Uniportal video-assisted thoracoscopic surgery (UVATS) right lower lobectomy for a giant T4 squamous cell lung tumour

R. Essa, Sirwan Khalid Ahmed, D. Bapir
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Abstract

Video-assisted thoracoscopic surgery (VATS) is one of the unique methods that have revolutionized the discipline of minimally-invasive thoracic surgery in the last two decades. Previously, double-port VATS lobectomy has been used for the resection of T4 tumours. This current case report presents a 68-year-old male that presented with a productive cough of 3 months' duration, associated with fever, chest pain and loss of body weight. He was haemodynamically stable. The patient underwent surgery under general anaesthesia using a uniportal VATS (UVATS) approach. A 2-cm incision was made in the mid-axillary line through the right 5th intercostal space with no rib spreading. The tumour was put into a specimen bag, cut into pieces and then removed via the mouth of the bag using a grasper. After good haemostasis, a single chest drain was placed and the small incision was sutured in layers. The postoperative course was uneventful and no complications were observed. On the 6th day postoperative, the patient was discharged home. This current case demonstrated that UVATS resection for T4 tumours might be a viable approach in the hands of skilled surgeons. It should also provide decreased postoperative pain, faster recovery and shorter hospitalization.
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单门视频胸腔镜手术(UVATS)右下肺叶切除术治疗巨大T4鳞状细胞肺肿瘤
在过去的二十年里,视频辅助胸腔镜手术(VATS)是一种独特的方法,它彻底改变了微创胸外科的学科。以前,双孔VATS肺叶切除术已被用于切除T4肿瘤。本病例报告涉及一名68岁男性,出现持续3个月的咳嗽,并伴有发热、胸痛和体重减轻。他的血流动力学稳定。患者在全身麻醉下采用单门静脉麻醉(UVATS)入路进行手术。经右侧第5肋间隙在腋窝中线处开2 cm切口,无肋骨扩张。肿瘤被放入一个标本袋,切成碎片,然后用钳子从袋子口取出。止血良好后,单胸腔引流,分层缝合小切口。术后过程平稳,无并发症发生。术后第6天,患者出院。目前的病例表明,在熟练的外科医生手中,UVATS切除T4肿瘤可能是一种可行的方法。它还应该减少术后疼痛,更快地恢复和缩短住院时间。
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