Right Lower Sleeve Lobectomy: Detailed Technique and Perioperative Patient Management.

Hidetoshi Inoue, Takuma Tsukioka, Nobuhiro Izumi, Kantaro Hara, Satoshi Suzuki, Takuya Tanimura, Noritoshi Nishiyama
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Abstract

Purpose: This report reviews our experience with right lower sleeve lobectomy and describes our technique and approach to perioperative patient management.

Methods: We retrospectively reviewed 11 patients who underwent right lower sleeve lobectomy for lung cancer. Surgical techniques and perioperative management were also investigated.

Results: Bronchoplasty was performed using 4-0 absorbable monofilament sutures. The deepest portion was anastomosed using continuous sutures; interrupted sutures were used for the more superficial portions. The truncus intermedius and right middle lobe bronchus should be anastomosed in a natural position. Anastomosis patency was confirmed using intraoperative bronchoscopy. Separation of the right upper and middle lobes and pericardiotomy at the inferior edge of the superior pulmonary vein are useful for mobilizing the right middle lobe. Death during hospitalization and treatment-related death did not occur. One patient developed pneumonia, and another developed a bronchopleural fistula.

Conclusion: We reported our technique of right lower sleeve lobectomy and our approach to perioperative patient management. Sharing knowledge is essential to completing this rare surgery.

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右下袖状肺叶切除术:详细技术和围手术期患者管理。
目的:本报告回顾了我们在右下袖状肺叶切除术方面的经验,并介绍了我们的技术和围手术期患者管理方法:方法:我们回顾性分析了 11 例接受右下袖状肺叶切除术的肺癌患者。方法:我们回顾了 11 例因肺癌接受右下袖状肺叶切除术的患者,并对手术技术和围手术期管理进行了调查:结果:使用 4-0 可吸收单丝缝线进行了支气管成形术。最深的部分采用连续缝合;较浅的部分采用间断缝合。中间截管和右中叶支气管应在自然位置吻合。吻合口的通畅性由术中支气管镜确认。分离右肺上叶和中叶以及在肺上静脉下缘进行心包切开术有助于移动右肺中叶。没有发生住院期间死亡和与治疗相关的死亡。一名患者出现肺炎,另一名患者出现支气管胸膜瘘:我们报告了右下袖状肺叶切除术的技术和围手术期患者管理方法。分享知识对于完成这种罕见手术至关重要。
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