The Utility of Muscle-Sparing Axillar Skin Crease Incision with Thoracoscopic Surgery in Children
The Utility of Muscle-Sparing Axillar Skin Crease Incision with Thoracoscopic Surgery in Children
复制标题
保留肌肉的腋窝皮肤折痕切口在儿童胸腔镜手术中的应用
DOI：
10.1089/lap.2018.0169
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发表时间：
2018
影响因子：
1.3
通讯作者：
Taguchi Tomoaki
中科院分区：
文献类型：
--
作者：
Souzaki Ryota;Kawakubo Naonori;Miyoshi Kina;Obata Satoshi;Kinoshita Yoshiaki;Takemoto Junkichi;Kohashi Kenichi;Oda Yoshinao;Taguchi Tomoaki
背景：胸腔镜手术治疗小儿良性肿瘤是一种常见的手术方式。然而，需要一个大切口才能从胸腔中切除大肿瘤。下叶肺内型隔离症有时需要大切口结扎迷走血管。保留肌肉的腋部皮肤折痕切口（MSASCI）已被引入胸部开放手术，与标准切口相比，其美学效果极佳。我们在此报告了MSASCI技术在胸腔镜手术中的实用性，以从胸腔中取出大型肿瘤并结扎下叶肺内隔离症中的迷走血管。材料和方法：从2014年4月至2016年3月，我们对5例儿童进行了MSASCI技术的胸腔镜手术。结果：5例患者被诊断为纵隔肿块（成熟畸胎瘤1例，神经节神经母细胞瘤2例，肺外隔离症和肺内隔离症各1例）。手术时年龄为32.0 ± 25.0个月（范围5-58个月）。纵隔肿块大小分别为9 × 5 × 5cm、4 × 3 × 3cm、5 × 5 × 2.5cm、3 × 2.5 × 2cm。对于其他4例病例，除了肺内隔离病例外，仅使用3或4个5 mm套管针在胸腔镜手术下切除肿块，并使用MSASCI技术从胸腔中取出肿块。对于肺内隔离症病例，仅使用两个5 mm和一个12 mm套管针在胸腔镜手术下切除迷走血管，并使用MSASCI技术进行左下叶切除术。所有病灶均完整切除。没有病例有手术并发症，没有复发，所有病例表现出良好的美容outcomes.Conclusions：使用MSASCI技术进行胸腔镜手术与良好的美容效果。
Background:Thoracoscopic surgery for pediatric benign tumors is a common procedure. However, a large incision is needed to remove large tumors from the thoracic cavity. And, for intrapulmonary sequestration in lower lobe, it sometimes needs a large incision to ligate the aberrant vessels. A muscle-sparing axillar skin crease incision (MSASCI) has been introduced for thoracic open surgery, resulting in excellent aesthetic outcomes compared with a standard incision. We herein report the utility of this MSASCI technique in thoracoscopic surgery to remove large tumors from the thoracic cavity and to ligate the aberrant vessels in intrapulmonary sequestration in lower lobe.Materials and Methods:From 2014 April to 2016 March, we performed the MSASCI technique in thoracoscopic surgeries for 5 children.Result:Five cases were diagnosed as mediastinal masses (mature teratoma for 1 case, ganglioneuroblastoma for 2 cases, and extrapulmonary sequestration and intrapulmonary sequestration for 1 case each). The age at surgery was 32.0 ± 25.0 months (range 5–58 months). The size of the mediastinal mass was 9 × 5 × 5 cm, 4 × 3 × 3 cm, 5 × 5 × 2.5 cm, and 3 × 2.5 × 2 cm. For 4 other cases, except for the intrapulmonary sequestration case, the mass was resected under thoracoscopic surgery using only three or four 5-mm trocars and the mass was removed from the thoracic cavity using the MSASCI technique. For the intrapulmonary sequestration case, the aberrant vessels were resected under thoracoscopic surgery using only two 5-mm and one 12-mm trocars and the left lower lobectomy was performed using the MSASCI technique. All lesions were resected completely. No cases had surgical complications, none showed recurrence, and all cases demonstrated good cosmetic outcomes.Conclusions:Performing thoracoscopic surgery using a MSASCI technique is associated with good cosmetic outcome.