经听诊三角的肌肉非损伤性开胸术

Muscle-sparing thoracotomy through the auscultatory triangle

目的 推荐一种经听诊三角的肌肉非损伤性开胸术。方法 我院共行 32例此类手术。切口是经肩胛骨下角作一弧形切口 ,不损伤背阔肌及前锯肌。结果 3例后纵隔肿瘤切除 ,2 2例肺叶切除 ,1例全肺切除 ,2例复发性气胸 ,1例肺活检 ,1例凝固性血胸纤维板剥脱 ,2例肋骨纤维结构不良切除。这种经听诊三角切口完全满足这些手术的需要 ,无需输血 ,无围手术期死亡 ,未出现严重并发症。结论 胸壁肌肉非损伤性开胸术操作简便、暴露充分 。

Objective To recommend the technique of muscle-sparing thoracotomy through the auscu ltatory triangle. Methods 32 patients with thoracotomy through the auscultatory triangle was made as a curvilinear incision around the of the scapu la, with preservation of both latissimus dorsi and serratus anterior muscles lo wer angle. Results The incision was adequate for all the operations including resection of posteri or mediastinal tumour (n=3); lobectomy (n=22); pneu monectomy (n=1); recurrent pneumothorax (n=2), lung biopsy (n=1), d ecortication of lung after coagulated hemothorax (n=1 case) and removal of f ibrous dysplasia of rib in two. There were no perioperative mortality, no se vere morbidity and no blood transfusion required.Conclusion This technique is simple with adequate exposure and will be useful for some se lected patients.