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机器人辅助纵隔肿瘤手术中国专家共识(2019版)

2020-01-01 中国医师协会 中国胸心血管外科临床杂志.2020,27(2):1-9.

纵隔是指左右两侧胸膜间隙及其内器官、结构和结缔组织的总称。纵隔肿瘤是纵隔内组织结构肿瘤性改变的统称,分为良性和恶性肿瘤。良性肿瘤如纵隔异位甲状腺、胸腺增生、纵隔囊肿、成熟性畸胎瘤、神经源性肿瘤等,恶性肿瘤如恶性胸腺瘤、胸腺癌、淋巴瘤、恶性神经源性肿瘤、生殖细胞肿瘤、纵隔内转移瘤等。纵隔空间狭小,结构复杂,组织来源多样,周围邻近大血管及心脏等重要脏器,目前治疗原则为仍以手术为主的综合治疗。传统开放性

中文标题:

机器人辅助纵隔肿瘤手术中国专家共识(2019版)

发布机构:

中国医师协会

发布日期:

2020-01-01

简要介绍:

纵隔是指左右两侧胸膜间隙及其内器官、结构和结缔组织的总称。纵隔肿瘤是纵隔内组织结构肿瘤性改变的统称,分为良性和恶性肿瘤。良性肿瘤如纵隔异位甲状腺、胸腺增生、纵隔囊肿、成熟性畸胎瘤、神经源性肿瘤等,恶性肿瘤如恶性胸腺瘤、胸腺癌、淋巴瘤、恶性神经源性肿瘤、生殖细胞肿瘤、纵隔内转移瘤等。纵隔空间狭小,结构复杂,组织来源多样,周围邻近大血管及心脏等重要脏器,目前治疗原则为仍以手术为主的综合治疗。传统开放性手术包括胸骨正中切口、胸骨部分劈开切口、蛤壳式切口、半蛤壳式切口、前外侧切口等,其胸骨或胸壁完整性受破坏,创伤大,出血多,暴露差,操作困难,手术时间长,术后疼痛明显,围手术期并发症较多。自 20 世纪以来,电视胸腔镜技术发展迅速,因其在手术切除率和临床效果与开放手术相同情况下,创伤更小,失血量更少,并发症发生率更低,目前在临床广泛推广使用。然而,纵隔内操作空间狭小,胸腔镜立体视觉感受差,胸腔镜器械较长,可能出现手部震颤,容易出现判断差错造成副损伤,且部分区域无法到达,切除难度大,对手术医师的技术要求较高。达芬奇机器人辅助手术因其能够提供更加精准、稳定、舒适的手术操作,能够更加微创、安全、彻底地完成肿瘤手术治疗,近年来逐渐在临床推广应用。我国 2006 年引进机器人手术系统并临床应用以来,国内一些医院成功开展了机器人辅助胸外科手术。随着机器人安装单位增加,机器人辅助纵隔肿瘤切除术者逐渐增多,稳定可传播的手术技术方法成为目前探索重点。

 

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    2021-12-05 1471d48dm72暂无昵称

    学习了

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    2021-09-30 ms1000001817409688

    0

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    2021-02-19 474576351

    不错

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    2021-01-20 ms6000001708878858

    喜欢这篇文章

    0

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