胸腔肺叶切除淋巴结清扫（图文演示）.docx

丁香叶网址::ead-22522-1-(图文演示)LYMPHADENECTOMYFORVIDEO-ASSISTEDPULMONARYLOBECTOMYAuthorsTNarukeAbstractThedescriptionofthelymphadenectomyforvideo-,positionofpatientandequipment,:regionallymphnodes,technique,radicallymphadenectomy,,(Video-assistedthoracicsurgery(VATS))可以相当程度地减少疼痛和缩短住院天数(Kaseda等人,1997)。VATS肺叶切除术是可行的,但是必须根据与传统肺叶切除术相同的肿瘤治疗原则(Naruke,1999),这意味必须行淋巴切除术才能完成手术。本章描述根据淋巴结分类的胸腔镜全身淋巴结切除(日本肺癌学会,TheJapanLungCancerSociety,2000;Naruke等人,1999)。,肺癌治愈标准手术需要完整切除肿瘤,以及沿着淋巴系统进行胸内的淋巴结切除。VATS肺叶切除术的适应症,目前局限于第1期癌症(Asamura等人,1996),理想的案例是直径小于4cm的周边肿瘤,手术技术和器械的改善,使得适应症范围可以扩大到更严重的癌症。VATS方式的禁忌症是:-病患无法忍受分段呼吸;-肿瘤侵犯到胸壁;-肿瘤侵犯到肺叶支气管;-胸膜粘连;-淋巴结发炎。?第2组丁香叶网址::ead-22522-1-.(上纵隔淋巴结)Superiormediastinallymphnodes2.(气管旁淋巴结)Paratracheallymphnodes3.(气管前淋巴结)Pretracheallymphnodes4.(气管支气管淋巴结)Tracheobronchiallymphnodes5.(主动脉下淋巴结)Subaorticlymphnodes6.(主动脉旁淋巴结)Para-aorticlymphnodes7.(隆突下淋巴结)Subcarinallymphnodes8.(食管旁淋巴结)Paraesophageallymphnodes9.(肺韧带淋巴结)Pulmonaryligamentlypmphnodes?第1b组10.(肺门淋巴结)Hylarlypmphnodes丁香叶网址::ead-22522-1-.