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首页> 外文期刊>Journal of Thoracic Disease >Uniportal video-assisted thoracoscopic lung sparing tracheo-bronchial and carinal sleeve resections
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Uniportal video-assisted thoracoscopic lung sparing tracheo-bronchial and carinal sleeve resections

机译：Uniportal视频辅助胸腔镜肺部备用气管支气管和催乳素套切除术

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摘要

Pathology arising from the intrathoracic portion of the trachea (distal trachea), the carina and the main bronchi is usually neoplastic and is mainly treated with surgery. Resection of the intrathoracic portion of the trachea, the carina and the main bronchi for neoplastic lesions does not necessitate lung resection and is traditionally being conducted via open surgery. Video-assisted thoracic surgery (VATS) is witnessing an exponential growth and is the treatment of choice for early-stage non-small cell lung cancer (NSCLC). The experience accumulated over the past two decades along with the introduction of reliable and ergonomic technology, has led to the expansion of its indications. In this article we provide a detailed description of lung sparing distal tracheal, carinal and main bronchi resection for primary neoplasms of the airway, without involvement of the lung, with the uniportal video-assisted technique. The chest is entered through the fourth intercostal space, mid-axillary line. Dissection of the paratracheal space anteriorly, the tracheoesophageal groove posteriorly and the subcarinal space and division of the azygos arch are essential to mobilize the distal trachea and carina. Lateral dissection should be avoided beyond the points of division of the airway, as it may hinder the blood supply to the anastomosis. Any tension to the anastomosis should be relieved by release maneuvers. Ventilation is achieved through an endobronchial catheter, inserted into the left main bronchus through which a high-frequency jet ventilation catheter can be also inserted through it. The rationale of applying a minimally invasive technique for the conduction of tracheal and carinal resections, is to exploit its advantages, namely less pain, earlier mobilization and lower morbidity. Uniportal video-assisted resections of the distal trachea, carina and the main bronchi, are safe when conducted by experienced surgical and anesthetic teams.
机译：来自气管的肺动脉内部（远端气管），克隆和主要支气管的病理学通常是肿瘤，主要用手术治疗。切除气管的胸腔内部分，胭脂瘤和主要支气管的肿瘤病变不需要肺切除，传统上通过开放手术进行。视频辅助胸部外科（VALS）目睹了指数增长，是治疗早期非小细胞肺癌的选择（NSCLC）。在过去二十年中积累的经验随着可靠和符合人体工程学的技术而导致其适应症的扩大。在本文中，我们提供对气道原发性肿瘤的肺部保留远端气管，粘骨和主要支气管切除的详细描述，无需肺的累伤，具有Uniportal视频辅助技术。胸部通过第四个肋间空间，中腋线进入。剖视向上剖开，前后气管气管沟和避免曲线拱的子沟槽和分裂对于动员远端气管和凸起是必不可少的。应该避免横向解剖超出气道的分裂点，因为它可能阻碍血液供应吻合。吻合术的任何紧张都应该通过释放机动来缓解。通过胚胎导管实现通风，插入左主支气管，通过该导管插入到左主支气管中，也可以通过该支气管插入其中。应用最微创技术的用于传导气管切除术的基本原理是利用其优点，即较少的疼痛，更早的动​​员和较低的发病率。由经验丰富的外科和麻醉团队进行时，Uniportal Trachea，Carina和Main Bronchi的分接切除，是安全的。

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