新辅助nivolumab联合铂类化疗后的机器人右下叶切除术。

Hitoshi Igai, Akinobu Ida, Kazuki Numajiri, Kazuhito Nii, Mitsuhiro Kamiyoshihara
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引用次数: 0

摘要

尽管nivolumab联合铂类化疗对患者的预后有好处,但由于胸腔尤其是肺门结构周围的炎症或纤维化,手术切除在技术上具有挑战性。使用微创方法进行这种复杂的手术切除需要机器人手术提供的优势,包括高清三维手术视野、精确、无震颤的运动和铰接式镊子,这有助于新辅助免疫化疗后的安全切除。在本视频教程中,我们演示了在新辅助尼夫单抗联合铂类化疗后进行的机器人右下肺叶切除术,重点介绍了其中涉及的具体技术和细微差别。手术时间为138分钟,失血量极少。患者术后恢复顺利;术后第 1 天(POD)拔除胸管,第 2 天出院。最终病理报告显示为 pTisN0M0,0 期,鳞状细胞癌。
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Robotic right lower lobectomy following neoadjuvant nivolumab combined with platinum-based chemotherapy.

Despite the prognostic benefits for patients, surgical resection following nivolumab combined with platinum-based chemotherapy is technically challenging due to the inflammation or fibrosis in the thoracic cavity, particularly around the hilar structures. Performing this complex surgical resection using a minimally invasive approach requires the advantages offered by robotic surgery, including a high-definition 3-dimensional surgical view, precise, tremor-free motion and articulated forceps, which facilitate safe resection following neoadjuvant immunochemotherapy. In this video tutorial, we demonstrate a robotic right lower lobectomy performed after neoadjuvant nivolumab combined with platinum-based chemotherapy, highlighting the specific techniques and nuances involved. The console time was 138 minutes, with minimal blood loss. The patient's postoperative course was uneventful; the chest tube was removed on postoperative day (POD) 1, and the patient was discharged on POD 2. The final pathological report revealed pTisN0M0, stage 0, squamous cell carcinoma.

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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
60
期刊介绍: The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.
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