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在先前切口术后的乳房修复:基于2200名患者数据库的临床实践审查和实践建议

Lisa M Kenney¹, Robert J Obermeyer^1,2

¹Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.

Journal of thoracic disease

|August 10, 2023

概括

在中骨切除术后,胸腔挖掘器的最小侵入性修复 (MIRPE) 具有独特的风险. 谨慎的策略,包括胸腔镜和直接剖析,可以优化手术结果,并尽量减少心脏损伤在这些复杂的情况下.

科学领域:

胸部外科手术胸部外科手术
儿科手术儿科手术
手术创新在外科创新.

背景情况:

胸部挖掘部的最小侵入性修复 (MIRPE) 是胸部挖掘部 (PE) 的标准程序.
经过先前中枢骨切除术的患者的修复是罕见的,并且由于背骨粘附而带有高危的阳性心脏损伤风险.
现有的文献提供了有限的指导,用于管理MIRPE在患者有史以来的胸腔切除.

研究的目的:

为了分析MIRPE的结果,在有中枢骨切除病史的患者中.
确定合理的策略,以优化手术结果,并最大限度地减少这种患者群体的并发症.

主要方法:

一个回顾性审查的9名患者接受了MIRPE在先前的椎切除术后在一个机构.
关于MIRPE在先前进行骨切割的患者中的文献综述.
对阳性心脏损伤发生率和促成因素的分析.

主要成果:

在9名患者中,有2人经历了阳性性心脏损伤.
这一小群体的发病率为22%,与多中心审查报告的7%相比.
由于样本规模较小,统计结论有限.

结论:

在先前切下骨的患者中,MIRPE是可行的,但需要仔细的规划和执行.
推的策略包括胸腔镜检查,常规的胸升高,直接的副胸背骨剖析,以及与心胸外科医生协调.
为心肺绕道术做好准备和大量输血协议的可用性对于管理潜在的并发症至关重要.

关键词:

这是Nuss程序.胸部挖掘物 (PE) 是指胸部挖掘物 (PE) 的意思.中间骨切除术最少侵入性修复胸部挖掘器 (MIRPE) 的方法

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