RS9 10BII的单层胸腔镜复合物结合了Seg-Subsementementementementementementementementementementementementementementementementsementement术：双解析方法和联合方法（反触发和跨粘结）
Uniportal Thoracoscopic Complex Combined Seg-Sub-subsegmentectomy of RS9+10bii: Dual-Display Method and Combined Approaches (Trans-fissure and Trans-ligament)
影响因子:3.50000
分区:医学2区 / 外科2区 肿瘤学3区
发表日期:2024 Nov
作者:
Junhao Wu, Chuan Li, Chengwu Liu
摘要
单皮胸腔镜侧基底切除术是技术上最具挑战性的解剖分割术，1-3，尤其是当它涉及组合亚段切除术或亚段切除术时。因此，很少有报道详细详细介绍其技术方面。在这篇多媒体文章中，我们描述了一种非常复杂的单层胸腔镜检查，将卢比的Seg-Sub-Smubsementementeptomy融合为rs9 10bii的Seg-sub-Smubsementement术通过倾斜裂缝方法和下部肺部韧带方法，在使用单个Direcontion策略4，yestrique Takele 4,5之后，以推动该步骤，以利用流程，以利用词干方法。分段/亚段/子分段结构跟踪，并采用双显示方法，其中包括静脉内ICG注入方法和通货膨胀/放气方法，以识别跨性段和se段和se段和se段的段平面。该操作持续了169分钟，持续了约20毫升的失血损失。该患者分别在术后第1、4和19天分别经历了活跃的血胸和两种自发性气胸，所有这些都在治疗后迅速解决。试样的组织病理学检查记录了具有阴性手术边缘和淋巴结的浸润性非粘液腺癌。该分期被确定为PT1BN0M0，IA2期。在14个月的随访期间，没有观察到肿瘤复发或转移的迹象。 FVC，FEV1和FEV1％PRED在术后6.com.plex基础分节切除术中分别下降了11.9％，12.5％和12.8％，需要使用Dual-Display和组合方法来实现rs9 10bii的基础分节切除术，这是必需的子段或子段分辨率组合的。该方法简化了非常复杂的组合子细分切除术的步骤，从而避免了对广泛的肺切除的需求。此外，在执行这些组合的分割切除术时，精确的解剖解剖对于防止并发症（例如较小的支气管脊髓瘘）至关重要。
Abstract
Uniportal thoracoscopic lateral basal segmentectomy is the most technically challenging anatomic segmentectomy,1-3 especially when it involves combined subsegmentectomy or sub-subsegmentectomy. Therefore, there are very few reports detailing its technical aspect.In this multimedia article, we describe a very complex uniportal thoracoscopic combined seg-sub-subsegmentectomy of RS9+10bii through the oblique fissure approach and the inferior pulmonary ligament approach, following a single-direction strategy4,5 to advance the procedure, utilizing the stem-branch method3,6 for segmental/subsegmental/sub-subsegmental structure tracking, and employing dual-display method, which comprises the intravenous ICG injection method and the inflation/deflation method, to identify intersegmental and inter-seg-sub-subsegmental planes.The operation lasted 169 min, with approximately 20 mL of blood loss. The patient experienced an active hemothorax and two spontaneous pneumothoraxes on postoperative days 1, 4, and 19, respectively, all of which resolved promptly after treatment. Histopathological examination of the specimen documented invasive non-mucinous adenocarcinoma with negative surgical margins and lymph nodes. The staging was determined as pT1bN0M0, stage IA2. During the 14-month follow-up period, there were no signs of tumor recurrence or metastasis observed. The FVC, FEV1, and FEV1%pred decreased by 11.9%, 12.5%, and 12.8%, respectively, at postoperative month 6.Complex basal segmentectomies, which necessitate combined subsegmental or sub-subsegmental resections, such as RS9+10bii, are feasible using the dual-display and combined approaches method. This method simplifies the steps of the very complex combined subsegmentectomy, averting the need for extensive lung resection. In addition, when performing these combined segmentectomies, precise anatomical dissection is crucial to prevent complications such as minor bronchopleural fistulas.