Résumé
Objective To investigate the feasibility of mini-incision muscle-sparing thoracotomy for pulmonary diseases. Methods The operation was performed through a subaxillary mini-incision along the 5th,6th,or 7th intercostals space and 8.5~13.5 cm in length.The latissimus dorsi muscle was pressed backwards,and the serratus anterior muscle was opened along the direction of muscle fibres.The intercostal muscles and the pleura were cut through along the midline between the two adjacent ribs or the superior border of the rib,for the resection of pulmonary benign or malignant lesions.Results The operation was successfully accomplished via mini-incision thoracotomy in all the 38 cases,including 17 cases of wedge resection,1 case of lesion resection of pulmonary sequestration,18 cases of lobectomy,1 case of lower right lobectomy,and 1 case of left total pneumonectomy.The duration of procedure was 50~150 min(mean,96 min),and the intraoperative blood loss was 100~400 ml(mean,220 ml).No complications were seen.Pleural effusion developed in 1 case postoperatively,and then subsided after drawing-off of fluid.Conclusions The mini-incision muscle-sparing thoracotomy has advantages of clear exposure and minimal invasion.But this procedure is not advisable in patients scheduled for a re-operation or with extensive pleural adhesion or tumor involvement to the chest wall.
Résumé
Objective To investigate the feasibility of minimally invasive muscle-sparing thoracotomy for gastric cardia tumor. Methods Minimally invasive muscle-sparing thoracotomy through the left 7th intercostal space was performed in 25 patients with gastric cardia tumor. Results Proximal gastrectomy and lower esophagectomy combined with esophagogastroanastomosis was performed in 20 patients with adenocarcinoma of gastric cardia and 4 patients with squamous cell carcinoma. Gastric fundus incision and tumor resection was conducted in 1 patient with hyperplastic polyps of gastric cardia. No perioperative mortality or serious complications were seen. Conclusions Minimally invasive muscle-sparing thoracotomy is simple and offers good exposure, being an alternative for carcinoma of gastric cardia in relatively early stages.