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常规肺切除的手术步骤为先结扎切断肺血管 ,然后再处理相应的支气管。经过多年临床实践 ,发现该手术模式有一定的局限性 ,尤其是对于肺门冻结、肺门巨大肿块、叶裂严重粘连或分化不全的患者 ,经肺门前方和叶裂处理肺血管就有一定的困难 ,甚至一部分患者因此而中止手术。自 1989年以来 ,选择性地在 48例难治性肺癌切除术中采用先断支气管的方法 ,经肺门后方显露肺血管及心包后壁 ,结合前心包切口 ,可以良好的环周显露肺血管、上腔静脉心包内段及左心房 ,有效地延长其长度和暴露空间 ,为处理上述结构提供了极大的便利和安全性 ,扩大了手术适应症 ,提高了手术切除率
The procedure for routine lung resection is to first ligate and sever the pulmonary vessels and then treat the corresponding bronchus. After many years of clinical practice, it was found that the surgical model has certain limitations, especially for patients with frozen hilum, massive hilar masses, severe fissures of adhesion or insufficiency of differentiation. With certain difficulties, even some patients stopped the operation. Since 1989, selective bronchial patency has been used in 48 cases of resectable lung cancer. The presence of pulmonary vascular and pericardial wall behind the hilum was combined with anterior pericardial incision to allow good circumferential visualization of the pulmonary vasculature. The superior vena cava pericardial segment and the left atrium effectively extend the length and exposure space, providing great convenience and safety for the treatment of the above structures, expanding the surgical indications, and improving the surgical resection rate.