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中华腔镜外科杂志(电子版) ›› 2022, Vol. 15 ›› Issue (02): 117 -119. doi: 10.3877/cma.j.issn.1674-6899.2022.02.012

病例报告 上一篇    

不插管单孔剑突下胸腔镜右全肺切除术一例
陈家军1, 张文天2,(), 陈坤3, 瞿冀琛2, 朱余明2, 蒋雷2   
  1. 1. 441021 襄阳,湖北省襄阳市中心医院心血管胸外科
    2. 200433 上海,同济大学附属肺科医院胸外科
    3. 713700 咸阳,泾阳县医院胸外科
  • 收稿日期:2021-07-24 出版日期:2022-04-30
  • 通信作者: 张文天

Nonintubated uniportal subxiphoid video-assisted thoracoscopic right pneumonectomy

Jiajun Chen1, Wentian Zhang2,(), Kun Chen3, Jichen Qu2, Yuming Zhu2, Lei Jiang2   

  1. 1. Department of Cardiovascular Thoracic Surgery, Xiangyang Center Hospital, Xiangyang 441021, China
    2. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Shanghai 200433, China
    3. Department of Thoracic Surgery, Jingyang Hospital, Xianyang 713700, China
  • Received:2021-07-24 Published:2022-04-30
  • Corresponding author: Wentian Zhang
目的

探讨不插管麻醉在单孔剑突下胸腔镜全肺叶切除术中的可行性和安全性。

方法

选取同济大学附属上海市肺科医院胸外科中央型非小细胞肺癌患者一例,术前完善检查,无手术禁忌,手术采用不插管麻醉在单孔剑突下胸腔镜右全肺切除术。

结果

患者术中和术后无意外及其他严重不良事件发生。

结论

不插管麻醉在单孔剑突下入路胸腔镜全肺手术中具有可行性和一定优势,更多支持证据尚需大规模临床对照研究。

Objective

To investigate the feasibility and safety of unintubated anesthesia in uniportal subxiphoid video-assisted thoracoscopic(VAT) right pneumonectomy.

Methods

A patient with central non-small cell lung cancer in the Department of Thoracic Surgery, Shanghai Pulmonary Hospital affiliated to Tongji University was selected. The preoperative examination was complete and there was no contraindication to the operation. The operation was performed with uniportal subxiphoid VAT right pneumonectomy without intubation anesthesia.

Results

There were no accidents or other serious adverse events during and after the operation.

Conclusions

Non-intubation anesthesia is feasible and certain advantages in uniportal subxiphoid VAT pneumonectomy. More supporting evidence still needs large-scale clinical controlled studies.

图1 右肺恶性肿瘤患者行不插管单孔剑突下胸腔镜右全肺切除术注:A. CT检查提示右肺门旁混合磨玻璃团块灶,恶性可能;B.电子支气管镜检查提示双侧各叶段管腔通畅;C.患者麻醉诱导后左侧卧位,沿剑突向下做4 cm切口;D.试漏关胸
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