“天平拉钩抬高胸骨法”在经剑突下单孔胸腔镜辅助前纵隔肿物切除术中的应用  

Application of"balance-shaped sternal elevation device"in the subxiphoid uniportal video-assisted thoracoscopic surgery for anterior mediastinal masses resection

作　　者：赵金兰 陈蔚洋 何春梅 熊宇 王蕾[2] 李洁[2] 林琳[2] 杨玉赏[2] 马林[2] 陈龙奇[2] 田东 ZHAO Jinlan;CHEN Weiyang;HE Chunmei;XIONG Yu;WANG Lei;LI Jie;LIN Lin;YANG Yushang;MA Lin;CHEN Longqi;TIAN Dong(Operating Room,Department of Anesthesiology,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,610041,P.R.China;Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院麻醉手术中心/四川大学华西护理学院,成都610041 [2]四川大学华西医院胸外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2025年第3期308-312,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的介绍一种创新技术—“天平拉钩抬高胸骨法”在经剑突下单孔胸腔镜辅助前纵隔肿物切除术中的应用。方法纳入2024年5—6月在四川大学华西医院胸外科行天平拉钩剑突下单孔胸腔镜辅助前纵隔肿物切除术患者,分析患者的临床资料。结果共纳入7例患者,其中男3例、女4例,年龄28~72岁。肿块长径1.9~17.0 cm,手术时间62~308 min,术中出血量5~100 mL,术后留置胸腔引流管0~9 d,术后第7天疼痛评分0~2分,术后住院时间3~12 d。所有患者均实现肿物及胸腺安全完整切除,术后恢复良好。结论“天平拉钩抬高胸骨法”可有效扩大胸骨后间隙,为术者提供满意的手术视野和操作空间,在提高前纵隔微创手术效果和安全性、减轻创伤和术后疼痛及加速患者康复等方面具有重要的临床意义和应用价值。Objective To introduce an innovative technique,the"balance-shaped sternal elevation device"and its application in the subxiphoid uniportal video-assisted thoracoscopic surgery(VATS)for anterior mediastinal masses resection.Methods Patients who underwent single-port thoracoscopic assisted anterior mediastinal tumor resection through the xiphoid process at the Department of Thoracic Surgery,West China Hospital,Sichuan University from May to June 2024 were included,and their clinical data were analyzed.Results A total of 7 patients were included,with 3 males and 4 females,aged 28-72 years.The diameter of the tumor was 1.9-17.0 cm.The operation time was 62-308 min,intraoperative blood loss was 5-100 mL,postoperative chest drainage tube retention time was 0-9 days,pain score on the 7th day after surgery was 0-2 points,and postoperative hospital stay was 3-12 days.All patients underwent successful and complete resection of the masses and thymus,with favorable postoperative recovery.Conclusion The"balance-shaped sternal elevation device"effectively expands the retrosternal space,providing surgeons with satisfactory surgical views and operating space.This technique significantly enhances the efficacy and safety of minimally invasive surgery for anterior mediastinal masses,reduces trauma and postoperative pain,and accelerates patient recovery,demonstrating important clinical significance and application value.

关 键 词：天平拉钩抬高胸骨法 前纵隔肿物 剑突下切口 单孔胸腔镜手术 

分 类 号：R734.5[医药卫生—肿瘤]