The Journal of the Japanese Association for Chest Surgery
Robot-assisted thoracoscopic right upper lobectomy for right upper lobe lung adenocarcinoma in patient with situs inversus totalis: Preoperative simulation using three-dimensional CT and horizontally flipped operative video
By Shoji Nishihara and Yasushi Cho.
Abstract
完全内臓逆位（situs inversus totalis）に合併した右上葉肺癌に対し，ロボット支援胸腔鏡下（以下RATS）右上葉切除を施行した．症例は68歳，女性．右上葉のすりガラス結節を認め手術適応と判断した．胸腹部CTで鏡像解剖（右位心，右側大動脈弓，右肺二葉）を把握し，通常解剖の左上葉切除動画を水平反転したシミュレーションを施行した．麻酔は右用double-lumen tubeで分離肺換気を行い，ファイバースコープで位置を確認した．RATS右上葉切除＋ND2a-1郭清を安全に完遂し，術後合併症なく第9病日に退院した．病理は浸潤性非粘液性腺癌，浸潤径11 mm，pT1bN0M0（IA2）であった．鏡像解剖例では，3D-CTと水平反転動画が手術戦略の共有と安全性向上に有用である．
Keywords
- Intestinal Malrotation and Obstruction Disorders
- Situs inversus
- Adenocarcinoma
- Lung
- Video-assisted thoracoscopic surgery
- Left lung
- Open access
Source
Published in The Journal of the Japanese Association for Chest Surgery. The abstract is shown as published and remains the work of its authors; read the full article at the source.
Prognia lists this article for reference and education. It is not medical advice. Always read the original and follow current guidelines and local protocols before acting on it.