医学部 呼吸器低侵襲外科学
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MISC
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ANNALS OF THORACIC SURGERY 97(2) 718-719 2014年2月We report a case of single-incision bilateral partial lung resection using the subxiphoid approach. This approach requires a 3-cm incision in the abdomen, making it aesthetically favorable. In addition, it does not cause postoperative intercostal neuropathy, and postoperative pain is minimal because the intercostal space is bypassed. Moreover, this technique enables exposure to both lungs through a single incision and has potential for widespread use if maneuverability can be increased by improving the instruments used. (C) 2014 by The Society of Thoracic Surgeons
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日本呼吸器外科学会雑誌 26(4) 373-379 2012年胸腔鏡下手術患者群において持続傍脊椎神経ブロックの有用性を後ろ向きに検討した．完全鏡視下肺切除術を行った連続した92名のうち32名で術中に傍脊椎神経ブロックを施し，術直後から0.2％塩酸ロピバカイン水和物注射液（アナペイン注2mg/ml），全量200 mlを3ml/時で持続投与した．同鎮痛法を行わない患者群と術後疼痛パラメーターを比較した．術当日から翌日の疼痛程度は傍脊椎神経ブロック施行群で有意に低値であった（Visual Analogue Scaleスコア平均値28±16 vs．43±18，p<0.01）．疼痛増強時の臨時鎮痛薬投与量は同鎮痛法施行群でより少なかった．同鎮痛法に関連した副作用はみられなかった．胸腔鏡下肺切除術患者において持続傍脊椎神経ブロックは安全で簡便，かつ有効な疼痛緩和法であった．
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ANNALS OF THORACIC SURGERY 93(1) 334-336 2012年1月We report a surgical procedure in which a port and devices designed for single-incision endoscopic surgery are employed for thymectomy through an infrasternal approach. As this single-port thymectomy procedure can be performed through a single 3.5-cm incision in the abdominal region usually concealed under clothes, it is esthetically excellent and is among the least invasive thymectomy procedures because no sternal incision is applied and no intercostal nerve is injured. Investigation of the safety of this procedure and long-term therapeutic outcomes for myasthenia gravis and anterior mediastinal tumors is necessary. (Ann Thorac Surg 2012;93:334-6) (C) 2012 by The Society of Thoracic Surgeons