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通过反转T上半脑切除术进行肺内关节切除术

Marie De Vos¹, Bart Meyns¹, Rozenn Anne Quarck²

¹Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.

JTCVS techniques

|December 13, 2024

概括

肺内关节切除术 (PEA) 的反转T上半关节切除方法是传统关节切除术的可行且安全的替代方案. 这种最少的侵入性技术产生了可比的血液动力学结果,并减少了阿片类药物的使用.

科学领域:

心血管外科心血管外科
胸部外科手术胸部外科手术
最少侵入性手术的方法

背景情况:

肺内关节切除术 (PEA) 是慢性血栓栓塞性肺高血压的关键治疗方法.
传统的PEA通常涉及全胸切除,这可能与严重的发病率有关.
探索少入侵的外科手术方法对于改善患者的治疗结果至关重要.

研究的目的:

为了评估PEA的反转T上半切除术的可行性和安全性.
为了比较这种新的方法与传统的全胸切除术的外科和血液动力学结果.

主要方法:

用7厘米的皮肤切口进行了17次PEA,并进行了反转T上半角切口.
心肺绕道 (CPB) 通过中枢动脉和皮肤穿透的股骨静脉管建立.
术后数据和血液动力学参数与之前的17种传统PEA进行了比较.

主要成果:

两组之间没有观察到CPB时间,深度低温循环停止持续时间或住院时间的显著差异.
手术后的肺血管阻力在反转T和常规骨切割组中表现出类似的改善.
在反转T上半切除组 (P < 1.10-4) 中,静脉内阿片类药物使用量明显降低.

结论:

倒置T上半切除术是PEA的可行和安全方法.
这种技术可以达到与全胸切除术相似的血液动力学结果,而不会增加CPB或循环停止时间.
它通过单个切口提供双边手术接入,并具有有限的禁忌.

关键词:

在CTEPH的基础上,半胸切除术 (hemisternotomy) 是一个半胸切除术.最小的访问手术手术.肺内关节切除术肺内关节切除术

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