肺移植手术切口发展历程和研究现状

徐坚; 邵景博; 陈员; 卫栋; 叶书高; 陈静瑜

doi:10.3969/j.issn.1674-7445.2024048

肺移植手术切口发展历程和研究现状

doi: 10.3969/j.issn.1674-7445.2024048

214023　江苏无锡，南京医科大学无锡医学中心无锡市人民医院南京医科大学附属无锡人民医院肺移植中心

基金项目: 国家自然科学基金面上项目（82070059）；无锡医学中心揭榜挂帅项目（WXKY202301001）

详细信息

作者简介:

通讯作者:
陈静瑜（ORCID 0000-0002-2127-1788），主任医师，研究方向为肺移植，Email：chenjy@wuxiph.com

中图分类号: R617, R563
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出版历程
- 收稿日期: 2024-02-14
- 网络出版日期: 2024-04-28
- 刊出日期: 2024-07-15

Development course and research status of incisions in lung transplantation

Wuxi Medical Center, Nanjing Medical University, Wuxi People's Hospital, Department of Lung Transplant Center, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China

More Information

Corresponding author: Chen Jingyu, Email: chenjy@wuxiph.com

摘要

摘要: 肺移植手术技术对于受者的临床预后有着显著的影响，选择合适的手术切口决定了术中的视野暴露，是手术顺利进行的第一步，直接影响后续的手术进程。肺移植切口通常默认一期关闭，但对于肺移植术毕存在如供肺过大、原发性移植物失功等高危因素患者，不能一期关闭切口，此时延迟关胸是一种应对策略。肺移植手术切口的选择及是否延迟关闭，对于肺移植围手术期预后、受者远期生存质量、手术并发症有着深远的影响。因此，本文结合国内外文献对肺移植Clamshell切口、前外侧切口、后外侧切口、胸骨正中切口的发展和研究现状进行综述，聚焦切口对肺移植预后的影响，为临床肺移植手术切口选择提供参考。
- 肺移植 /
- 手术入路 /
- Clamshell切口 /
- 前外侧切口 /
- 后外侧切口 /
- 胸骨正中切口 /
- 延迟关胸 /
- 手术部位感染
Abstract: Surgical technique of lung transplantation exerts significant impact on clinical prognosis of the recipients. Choosing an appropriate surgical incision determines the exposure of intraoperative visual field, which is the first step of surgical success and directly affects subsequent surgical procedures. Lung transplantation incision is usually considered as primary closure. Nevertheless, for patients with high-risk factors such as oversized lung allografts and primary graft failure after lung transplantation, primary closure cannot be achieved. Hence, delayed chest closure is an effective strategy. The selection of incisions and the adoption of delayed chest closure of lung transplantation exert profound impact upon perioperative prognosis, long-term quality of life and surgical complications of the recipients. Therefore, the development and research status of Clamshell incision, anterolateral incision, posterolateral incision and median sternal incision in lung transplantation were reviewed, highlighting the effect of incision patterns on clinical prognosis of lung transplantation and providing reference for the selection of incisions in clinical lung transplantation.
- Lung transplantation /
- Surgical approach /
- Clamshell incision /
- Anterolateral incision /
- Posterolateral incision /
- Median sternal incision /
- Delayed chest closure /
- Surgical site infection

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FIG. 3262. FIG. 3262.

FIG. 3262.. FIG. 3262.

下载: 全尺寸图片幻灯片

图 1 肺移植经典手术入路

注：A为Clamshell切口；B为前外侧切口（右侧切口右侧视图）；C为后外侧切口（右侧切口俯视）；D为胸骨正中切口。

Figure 1. Classical surgical approaches of lung transplantation

下载: 全尺寸图片幻灯片

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