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中华胸部外科电子杂志 ›› 2024, Vol. 11 ›› Issue (02) : 130 -142. doi: 10.3877/cma.j.issn.2095-8773.2024.02.09

综述

剑突下入路胸腔镜纵隔手术技术及其进展
莫安胜1,(), 王国正2, 宾能康3, 郑昌泽3   
  1. 1. 530200 南宁,广西中医药大学研究生院;530199 南宁,广西医科大学附属武鸣医院心胸外科
    2. 530200 南宁,广西中医药大学研究生院
    3. 530021 南宁,广西医科大学研究生院
  • 收稿日期:2024-02-07 修回日期:2024-03-18 接受日期:2024-05-09 出版日期:2024-05-28
  • 通信作者: 莫安胜
  • 基金资助:
    2023年广西医疗卫生适宜技术开发与推广应用项目(S2023098)

Technique and advancements of subxiphoid video-assisted thoracoscopic surgery for anterior mediastinal disease

Ansheng Mo1,(), Guozheng Wang2, Nengkang Bin3, Changze Zheng3   

  1. 1. Graduate School, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China; Department of Cardiothoracic Surgery, Wuming Hospital of Guangxi Medical University, Nanning 530199, China
    2. Graduate School, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China
    3. Graduate School, Guangxi Medical University, Nanning 530021, China
  • Received:2024-02-07 Revised:2024-03-18 Accepted:2024-05-09 Published:2024-05-28
  • Corresponding author: Ansheng Mo
引用本文:

莫安胜, 王国正, 宾能康, 郑昌泽. 剑突下入路胸腔镜纵隔手术技术及其进展[J]. 中华胸部外科电子杂志, 2024, 11(02): 130-142.

Ansheng Mo, Guozheng Wang, Nengkang Bin, Changze Zheng. Technique and advancements of subxiphoid video-assisted thoracoscopic surgery for anterior mediastinal disease[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2024, 11(02): 130-142.

近年来,剑突下入路胸腔镜手术因其良好的临床疗效而在全国逐渐推广。应用剑突下入路胸腔镜手术可以治疗前纵隔疾病。但剑突下入路胸腔镜纵隔手术是一种仍然在发展和推广中的技术,需要应用者对该技术有全面的了解以便更好地应用该技术。本文就经剑突下手术入路胸腔镜纵隔手术技术及最新研究结果作一综述,以供大家有全面的了解。

In recent years, subxiphoid video-assisted thoracoscopic surgery has been increasingly applied as a new approach for anterior mediastinal disease in China due to its excellent clinical outcomes. However, subxiphoid thoracoscopic mediastinal surgery is a technique that is still being developed and promoted, and requires users to have a comprehensive understanding of the technique in order to better apply it. Herein, we provide a review of the technique and its latest advancements for a more comprehensive understanding for the users.

图1 平卧分腿位
图2 剑突下三切口胸腔镜手术
图3 剑突下三切口胸腔镜手术(操作孔与前正中线水平距离10 cm)
图4 剑突与膈肌关系图(胸部CT)。A:矢状位;B:冠状位
图5 剑突下单孔胸腔镜手术
图6 剑突下五孔胸腔镜手术
图7 经剑突及肋间切口胸腔镜手术
图8 经剑突下切口及肋间切口胸腔镜手术
图9 经剑突下及肋间切口胸腔镜手术
图10 经剑突下、颈部及肋间切口胸腔镜手术
图11 经剑突下切口密闭的改良方法。A:无菌外科手套与直径5 cm的商品化切口保护器连接;B:用无菌外科手套及弹性环自制的切口保护器;C:商品化多通道切口保护器
图12 经剑突下切口密闭的改良方法手术中呈现[13](本图片已获得《中国医药》授权使用)
图13 胸骨拉钩通常选择的置入点
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