神戸大学附属図書館デジタルアーカイブ
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https://hdl.handle.net/20.500.14094/0100483310
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2024-06-04
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0100483310 (fulltext)
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メタデータID
0100483310
アクセス権
open access
出版タイプ
Version of Record
タイトル
Procedure of uniportal intercostal bullectomy for pneumothorax and its indications: a clinical practice review
著者
Nishioka, Yuki ; Hokka, Daisuke ; Maniwa, Yoshimasa
著者ID
A3026
著者名
Nishioka, Yuki
西岡, 祐希
ニシオカ, ユウキ
所属機関名
医学部附属病院
著者ID
A1484
研究者ID
1000080715459
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=9a37cb0e45c284b2520e17560c007669
著者名
Hokka, Daisuke
法華, 大助
ホッカ, ダイスケ
所属機関名
医学研究科
著者ID
A0782
研究者ID
1000050362778
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=5a0f3a6ba5a3f888520e17560c007669
著者名
Maniwa, Yoshimasa
眞庭, 謙昌
マニワ, ヨシマサ
所属機関名
医学研究科
収録物名
Video-Assisted Thoracic Surgery; Vol 8 (September 30, 2023): Video-Assisted Thoracic Surgery
巻(号)
8
ページ
31
出版者
AME Publishing Company
刊行日
2023-09-30
公開日
2023-10-05
抄録
Uniportal video-assisted thoracoscopic surgery (VATS), which is predominantly performed with an intercostal approach, has been gaining popularity as a less invasive surgical treatment for bullectomy. With the widespread use of this procedure, the number of reports on surgical outcomes has increased. With the advent of the transareolar or subxiphoid approach, there is an increasing need to discuss the indications for these approaches in order to establish evidence. Therefore, we aimed to summarize the intercostal procedures of uniportal VATS for pneumothorax and discuss the favorable indications for this approach. In terms of indications, the pneumothorax size of the patients treated by surgery has not been elucidated and needs to be clarified for the indication. Considering the indications and outcomes of uniportal intercostal VATS, the presence of bullae may be a favorable indication for the procedure. Additionally, initial surgery for pneumothorax is the preferable indication, since pleural adhesion was an exclusion criterion for performing uniportal VATS. To reduce invasiveness, postoperative prolonged air leakage should be minimized, and the causes should be investigated. Each approach has its own advantages owing to anatomical differences. The distribution of the responsible lesions can be an indication for these approaches. Both the transareolar and intercostal approaches allow for resection of the apex of the lung. The intercostal approach can be superior to the other two approaches for resecting posterior lesions. From the perspective of cosmesis and invasiveness, a transareolar approach may reduce the involvement of the intercostal nerve and it can be performed without any recognizable scarring. The subxiphoid approach eliminates the involvement of the intercostal nerve and offers favorable access to the bilateral thoracic cavity. An intercostal approach can cause intercostal nerve involvement, but the incision used for the placement of the preoperative drain tube in the lateral thorax can also be used as an operative incision with this approach. Moreover, this approach allows for the easy exploration of the whole lung in order to avoid overlooking any bullae, and its lateral decubitus position is favorable when an additional incision is needed in the case of unexpected situations, such as adhesion.
キーワード
Pneumothorax
bullectomy
uniportal video-assisted thoracoscopic surgery
intercostal approach
カテゴリ
医学研究科
医学部附属病院
学術雑誌論文
権利
© Video-Assisted Thoracic Surgery. All rights reserved.
This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license).
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資源タイプ
journal article
言語
English (英語)
eISSN
2519-0792
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関連情報
DOI
https://doi.org/10.21037/vats-23-30
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