VATS左肺上叶尖后段双肺段切除术

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Author：Joel Dunning

Video Description：该视频展示的为一例肺功能受损患者行左肺上叶尖后段切除术，并保留肺小舌和前段。该部分的肺动脉被首次鉴别、环绕并用吻合器切除。然后该肺段支气管被鉴别出并吻合。这样该肺段静脉的可视化程度非常好。这些都是在膨胀之前进行，确认吻合线，并吻合新裂缝。

对于肺左上叶尖后段存在较小肿瘤的患者而言，这是一种特别好的选择；这种患者如果行左上叶切除术可能会严重影响其长期肺功能。该后段切除方法可在所有相关节段血管的可视性俱佳的情况下进行。

This video demonstrates a left upper lobe posterior and apical segmentectomy, preserving the lingular and anterior segment, in a patient with impaired lung function. The segmental pulmonary arteries are first identified, encircled, and taken with a stapler. Then the segmental bronchi are identified and stapled. This allows an excellent view of the pulmonary segmental veins. These are taken prior to inflation, to identify the line of stapling to complete the new fissure.

This is an excellent option for patients who have small tumors in the posterior or apical segments of the left upper lobe, in whom a full left upper lobectomy might significantly impair their long-term lung function. The posterior approach allows an excellent view of all the relevant segmental vessels.