支气管的分支模式和右上叶的体积:对细分切除术规划的影响
Kentaro Miura1, Takashi Eguchi1, Shogo Ide1
1Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Interdisciplinary cardiovascular and thoracic surgery
|August 17, 2023
概括
了解右上叶的支气管分支模式对于安全的肺部切除术至关重要. 卷度分析显示了异质的细分分布,非占优势的细分由于复杂的分支而带来更高的风险.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部解剖学 肺部解剖学
- 医学成像医学成像
背景情况:
- 分段切除术越来越多地用于肺癌治疗.
- 对细分支气管解剖学的详细理解是有限的.
- 准确的解剖学知识对于安全有效的断片切除手术至关重要.
研究的目的:
- 为了研究支气管分支模式的复杂性和右上肺叶的细分体积.
- 为了提高对细分解剖学的理解,以改善肺部细分解剖.
- 确定影响手术安全性和效率的解剖学因素.
主要方法:
- 分析了303名患者的胸部计算机断层扫描 (CT) 扫描.
- 分段性支气管分支 (1-3段) 被分为4种类型和11种亚型.
- 进行了细分体积测量,以确定占主导地位的细分,并评估分支复杂性.
主要成果:
- 最常见的分支类型是三叉式无缺陷 (64.4%).
- 大多数案例显示出一个细分市场占主导地位的分布 (71%),其中3细分市场占主导地位的比例为52%.
- 卷度非占主导地位的细分市场显示,复杂分支模式的发病率更高 (37%对19%).
结论:
- 右上叶部分体积分布是异质的.
- 由于复杂的支气管分支,体积测量非主导段在分段切除过程中具有更高的风险.
- 细分切除术的手术规划应考虑支气管解剖学和细分体积的个体变化.
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