本研究是根据赫尔辛基宣言和当地临床伦理委员会 （2018/09） 进行的。
1. 体格检查
注意:用于诊断 TOS 的激发试验如 图 1 所示。
<ol><li>对于Adson试验（斜角肌试验， 图1A），使患者的肩部向外旋，轻微外展和一点点伸展，并触诊桡动脉搏动。将患者的头部向后伸展并旋转到被测试的肩膀。让患者吸气并屏住呼吸。<ol><li>如果症状再现或桡动脉搏动消失，而症状随着头部向对外侧旋转而消退，则考虑检测阳性。</li>
	</ol></li>
	<li>对于肋锁支具测试（图1B），将患者的手臂向后，在同侧压下并缩回患者的肩胛骨。检查脉搏。如果桡动脉搏动消失或症状再次出现，则认为该检测呈阳性。</li>
	<li>对于过度外展试验（图1C），稍微伸展患者的手臂并触诊桡动脉。将手臂外展 90-180°。阳性测试是指桡动脉脉搏从基线到新位置的降低。</li>
	<li>对于Roos（East）测试（图1D），以坐姿或站姿进行测试。将患者的肩膀外展至 90°，向外旋转，肘部弯曲至 90°。肘部应略微落后于正面平面。让患者张开和合上双手 3 分钟。<ol><li>如果患者感到手臂沉重、缺血性疼痛或无力或手麻木和刺痛，则考虑检测呈阳性。手的变色对测试也很有意义。 注意:手术治疗是 VTOS 病例的首选，而 NTOS 病例的手术治疗是在保守治疗 3 个月后进行的，他们的日常生活、工作生活和睡眠质量没有任何改善。</li>
	</ol></li>
</ol>2. 术前临床和电诊断评估
<ol><li>为了评估手术治疗的临床改善情况，请在体格检查、肌电图检查结果和与日常活动症状以及术前社会和心理症状相关的 QuickDASH（手臂、肩部和手部残疾: <a href="https://www.hss.edu/physician-files/fufa/Fufa-quickdash-questionnaire.pdf">https://www.hss.edu/physician-files/fufa/Fufa-quickdash-questionnaire.pdf</a>）问卷中做出临床发现。</li>
	<li>通过测量复合运动动作电位 （CMAP）、感觉神经动作电位 （SNAP） 和神经传导速度 （NCV） 和 F 波潜伏期来确定术前肌电图。使用商用 EMG/NCV/EP 测量系统（例如 Nihon Kohden Neuropack 2）进行记录。</li>
</ol>3.经腋窝第一肋骨切除术
<ol><li>使用标准麻醉诱导方案进行麻醉，其中包括 0.6 mg/kg 罗库溴铵、0.05 mg/kg 咪达唑仑和 1-2 μg/kg 芬太尼。</li>
	<li>给予 6 mg/kg 的噻喷他钠以维持治疗。</li>
</ol>4. 患者体位（图2）
<ol><li>将患者置于侧卧位后，包裹手臂，抬高并悬挂在 90° 外展位。如果需要，每 3-5 分钟减少牵引力，以防止术后并发症。</li>
	<li>使用10%无菌聚维酮碘溶液进行局部灭菌。悬垂手臂、腋窝和胸部。在身体其他部位使用无菌床单以防止污染。</li>
</ol>5. 到达第一根肋骨
<ol><li>手术器械的使用如 图 3 和 材料表所示。</li>
	<li>在腋窝发际线下方横向切开一个切口，从胸大肌向前延伸，背阔肌向后延伸，长度为 5-7 厘米。</li>
	<li>穿过皮肤、皮下组织和筋膜到达前胸壁。</li>
	<li>使用钝性解剖到达第一根肋骨。</li>
</ol>6. 从肌肉和筋膜中释放第一根肋骨
<ol><li>刺穿覆盖在第一肋骨上方的筋膜，并解剖覆盖在肋骨上部的骨膜。使用单极烧灼术和肋骨刮刀钝地从周围肌肉中解剖肋骨的下缘。</li>
	<li>将肋间肌肉分开，直到胸肋交界处的肋锁韧带和肋脊后交界处的角肋骨。</li>
	<li>在第一肋骨的上缘，前斜角肌前方和中斜角肌后方暴露。将弯曲的镊子放在前斜角肌和中斜角肌下方，以在第一肋骨上插入的水平处切割肌肉，在那里它们离神经血管束最远。</li>
</ol>7. 切除第一肋骨或颈肋骨
<ol><li>开始切除胸肋前交界处的第一根肋骨。首先，从其上边缘转动，然后从下边缘转动，使用胸骨上的肋骨切割器将其切除。确保神经血管结构得到保留。</li>
	<li>之后，切除肋骨的后部，并分离位于肋骨角远端的部分;因此完成肋骨切除术。</li>
	<li>将颈肋从周围组织中完全释放后，切除并分离肋骨，直到看到横突的关节面。</li>
</ol>8. 术后时期
<ol><li>在术后，进行胸部 X 线检查以排除并发症，例如胸腔炎。</li>
	<li>在术后第 1 天移除胸腔引流管，如果情况不大。</li>
	<li>使用非甾体抗炎药、麻醉镇痛药和肌肉松弛剂治疗术后疼痛。</li>
	<li>在术后早期，检查手臂在手术侧的运动。术后前两个月继续物理治疗。</li>
	<li>建议患者不要在手术侧进行任何令人筋疲力尽的活动。</li>
</ol>9. 术后临床和电诊断评估
<ol><li>为了评估手术治疗的临床改善，比较体格检查、肌电图检查结果和 QuickDASH（手臂、肩部和手部残疾: <a href="https://www.hss.edu/physician-files/fufa/Fufa-quickdash-questionnaire.pdf">https://www.hss.edu/physician-files/fufa/Fufa-quickdash-questionnaire.pdf</a>）问卷中的临床结果，这些问卷与日常活动症状以及术前和术后（3 个月）相关的社会和心理。</li>
	<li>通过测量复合运动动作电位 （CMAP）、感觉神经动作电位 （SNAP）、神经传导速度 （NCV） 和 F 波潜伏期来比较术前和术后肌电图。使用商用 EMG/NCV/EP 测量系统（例如 Nihon Kohden Neuropack 2）进行记录。</li>
	<li>术后进行体格检查，评估疼痛和感觉异常。</li>
</ol>

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TFRR 是治疗 TOS9、10、11 最常用的手术技术。TFRR 的优点是它提供了更好的美容效果，在腋窝有一个隐藏的切口，而无需切割肌肉以到达手术区域。它的缺点是工作空间相对狭窄和深。锁骨上入路是动脉 TOS 治疗的首选方法，可降低锁骨下动脉损伤的风险12。锁骨下静脉在静脉 TOS 治疗中常采用锁骨下入路，后外?...

斜角三角臂丛神经、锁骨下动脉或静脉的压迫在临床上称为胸廓出口综合征 （TOS），最初由 Peet 等人描述1。胸廓出口综合征根据潜在病因细分为神经源性 （NTOS）、动脉 TOS 和静脉 TOS1。NTOS患者（93-95%的TOS病例）表现为疼痛、麻木和同侧无力。静脉 TOS 患者 （3-5%） 表现为静脉血栓形成，动脉 TOS 患者 （1-2%） 表现为动脉血栓栓塞事件和缺血。TOS的保守治疗包括药物治疗和物理治疗，是TOS病例的首选。手术治疗方式包括减压手术，并在保守治疗失败后进行2.减压技术包括经腋窝第一肋骨切除术 （TFRR）、锁骨上第一肋骨切除术 （SFRRS）、扁平体切除术（无需通过锁骨上或经腋窝切除第一肋骨）和后入路第一肋骨切除术 （PA-FRR）3。经腋窝第一肋骨切除术是 Roos 等人于 1966 年描述的一种技术，是治疗 TOS 4,5 的有效方法。TFRR 的主要目标是完全切除最后一根颈肋和第一根胸肋骨，并减压下面的神经血管束。
血管 TOS （VTOS） 通过 CT 血管造影、彩色双功 USG 和动脉造影或静脉造影进行诊断，而 NTOS 通过 X 射线、电诊断检查（针脊髓电图）、彩色双功多普勒 USG 和颈部 MRI 进行诊断。术前应咨询物理治疗师和精神科医生，以排除其他疾病。在前斜角肌注射利多卡因缓解症状也是诊断和预测 NTOS 患者手术获益的良好指标6。

<table><tbody><tr><td>Ag Debakey vascular forceps 24 cm, 3.5 mm</td><td>Lawton medizintechnik</td><td>30-0032</td><td>Check the hemorrhage</td></tr><tr><td>Bone chisels curved 13x9.1/2&#039;&#039;</td><td>Aesculap Inc.</td><td>MB-992R</td><td>Dissect the periost of the first rib</td></tr><tr><td>Doyen-stille retractor 24 cm</td><td>Lawton medizintechnik</td><td>20-0650</td><td>Skin- muscle retraction</td></tr><tr><td>Foerster sponge forceps straight</td><td>Lawton medizintechnik</td><td>07-0156</td><td>For swabbing</td></tr><tr><td>Luer stille bone rongeur curved 27 cm</td><td>Lawton medizintechnik</td><td>38-0703</td><td>Bone punches</td></tr><tr><td>Luer stille rongeur straight 22 cm</td><td>Lawton medizintechnik</td><td>38-0400</td><td>Rib cutter</td></tr><tr><td>Mayo hegar needle holder 20.5 cm</td><td>Lawton medizintechnik</td><td>08-0184</td><td>Suturing</td></tr><tr><td>Metzenbaum scissors curved delicate 23 cm</td><td>Lawton medizintechnik</td><td>05-0665</td><td>Dissection</td></tr><tr><td>Overholt curved forceps delicate 30.5 cm</td><td>Lawton medizintechnik</td><td>06-0807</td><td>Split the scalen muscles from the rib</td></tr><tr><td>Roberts art forceps straight 24 cm</td><td>Lawton medizintechnik</td><td>06-0370</td><td>For sponge and remove remain bone</td></tr><tr><td>Roux retractor medium size 15.5 cm</td><td>Lawton medizintechnik</td><td>20-0402</td><td>Wound retraction</td></tr><tr><td>Semb rasparotry 22,5 cm, 12mm</td><td>Lawton medizintechnik</td><td>39-0252</td><td>Dissect the muscle of the first rib</td></tr><tr><td>Smith peterson model curved osteotome 13x205 mm</td><td>Lawton medizintechnik</td><td>46-0783</td><td>Dissect the muscle of the first rib</td></tr><tr><td>Stille -giertz rib shears 27 cm</td><td>Lawton medizintechnik</td><td>38-0200</td><td>First rib cutting</td></tr><tr><td>Stille osteotome 8x205 mm</td><td>Lawton medizintechnik</td><td>46-0248</td><td>Dissect the periost of the first rib</td></tr><tr><td>Wagner rongeur 5.5x210 mm</td><td>Lawton medizintechnik</td><td>53-0703</td><td>Punches</td></tr></tbody></table>

transaxillary first rib resection for treatment of the thoracic outlet syndrome

胸廓出口综合征 （TOS） 是一种常见的疾病，会导致生产力显着下降。经腋窝第一肋骨切除术 （TFRR） 方案已用于 TOS 中受困神经血管结构的减压。在其他外科手术中，TFRR 的优点是复发率最低，美容效果更好。TFRR 的缺点是它提供了一个狭窄而深的工作走廊，这使得获得血管控制具有挑战性。

临床结果 本研究共纳入15例患者。3例患者（20%）为男性，12例（80%）为女性。患者平均年龄分别为30.6岁±8.98岁。所有男性参与者和 5 名女性参与者都是体力劳动者。NTOS组最常见的主诉是手臂-前臂疼痛和麻木、握力无力和低水萎缩。在术后临床随访中，询问患者的感觉异常和疼痛严重程度、总体满意度、活动和工作状态。在术前和术后评估QuickDASH评分和EMG值。术前和术后肌电图测?...

Watch this Scientific Journal Video about Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome at JoVE.com

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

在这里，我们提出了第一肋骨经腋窝切除术的方案，用于治疗由臂丛神经、锁骨下静脉和动脉受压引起的胸廓出口综合征。

经腋窝第一肋骨切除术治疗胸廓出口综合征

Thoracic outlet syndrome (TOS) is a common disorder that causes a significant loss of productivity. The transaxillary first rib resection (TFRR) protocol ...

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2.8K 次观看.  Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital. 在这里，我们提出了第一肋骨经腋窝切除术的方案，用于治疗由臂丛神经、锁骨下静脉和动脉受压引起的胸廓出口综合征。

视频: Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Aortic valve stenosis has become the most prevalent valvular heart disease in developed countries, and is due to the aging of these populations. The incidence of the pathology increases with growing age after 65 years. Conventional surgical aortic valve replacement through median sternotomy has been the gold standard of patient care for symptomatic aortic valve stenosis. However, as the risk profile of patients worsens, other therapeutic strategies have been introduced in an attempt to maintain the excellent results obtained by the established surgical treatment. One of these approaches is represented by transcatheter aortic valve implantation. Although the outcomes of high-risk patients undergoing treatment for symptomatic aortic valve stenosis have improved with transcatheter aortic valve replacement, many patients with this condition remain candidates for surgical aortic valve replacement. In order to reduce the surgical trauma in patients who are candidates for surgical aortic valve replacement, minimally invasive approaches have garnered interest during the past decade. Since the introduction of right anterior thoracotomy for aortic valve replacement in 1993, right anterior mini-thoracotomy and upper hemi-sternotomy have become the predominant incisional approaches among cardiac surgeons performing minimal access aortic valve replacement. Beside the location of the incision, the arterial cannulation site represents the second major landmark of minimal access techniques for aortic valve replacement. The two most frequently used arterial cannulation sites include central aortic and peripheral femoral approaches. With the purpose of reducing surgical trauma in these patients, we have opted for a right anterior mini-thoracotomy approach with a central aortic cannulation site. This protocol describes in detail a technique for minimally invasive aortic valve replacement and provides recommendations for patient selection criteria, including cardiac computer tomography measurements. The indications and limitations of this technique, as well as its alternatives, are discussed.

The goal of this protocol is to describe in detail the technique of minimally invasive aortic valve replacement through a right anterior mini-thoracotomy and central aortic cannulation. This technique can potentially enhance patients&#39; comfort and, by reducing post-operative morbidity, promote lowering the length of stay and global costs.

右前小切口主动脉瓣置换术的技术及患者选择标准

Aortic valve stenosis has become the most prevalent valvular heart disease in developed countries, and is due to the aging of these populations. The ...

科研

医学

Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy

Esophagectomy remains the preferred option to achieve curative treatment in advanced esophageal cancer, but the choice of surgical approach remains controversial. A transthoracic approach may improve lymph node dissection, but it has considerable morbidity and respiratory complications. Transhiatal access has been demonstrated as an efficient means of minimizing post-operative complications. Minimally invasive transhiatal esophagectomy may reduce operative trauma and morbidity as well as enhance postoperative recovery with no compromise in cancer recurrence or survival. Nevertheless, it has a technical limitation in terms of cervical esophagus dissection. Thus, a low-cost single-port device was developed to complete upper mediastinal dissection by a transcervical approach during minimally invasive transhiatal esophagectomy. This device uses a nasogastric tube, a number-eight sterile glove, a sterile sponge, and 3 permanent 5-mm trocars. The step-by-step process of transhiatal esophagectomy and the development of this device are described. This technique allows for the dissection of the upper mediastinum, as well as the esophagus over the aortic arch and behind the superior portion of the trachea. The harvesting of lymph nodes along the left recurrent laryngeal nerve and paratracheals was improved.

Low-Cost Single-Port LoCoSP Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy

Here, we describe a step-by-step description of transhiatal esophagectomy and the development of a low-cost single-port device for a transcervical approach in a minimally invasive transhiatal esophagectomy.

低成本单端口 （LoCoSP） 设备，用于微创性跨侵入性食管切除术中的内脏方法

Esophagectomy remains the preferred option to achieve curative treatment in advanced esophageal cancer, but the choice of surgical approach remains ...

Laminectomy for the Removal of Thoracic Ossification of the Ligamentum Flavum (TOLF) Using Ultrasonic and Conventional Osteotomes

Thoracic ossification of the ligamentum flavum (TOLF) is a common cause of progressive thoracic myelopathy. TOLF is typically treated with surgical decompression. A variety of surgical techniques, including laminoplasty, laminectomy, and lamina fenestration, are used for the effective treatment of TOLF. However, traditional methods are associated with a substantial risk of perioperative complications, including dural laceration and/or iatrogenic spinal cord injury. Therefore, it is important to develop an efficient and secure surgical technique for TOLF. Herein, we describe a method for laminectomyperformed at the thoracic spine using an ultrasonic osteotome combined with a conventional osteotome. This technique can reduce intraoperative complications. This is a relatively safe and easy-to-learn method that should be recommended for the treatment of TOLF.

Laminectomy for the Removal of Thoracic Ossification of the Ligamentum Flavum TOLF Using Ultrasonic and Conventional Osteotomes

We present a methodology for using an ultrasonic osteotome combined with a conventional osteotome for laminectomy in thoracic ossification of the ligamentum flavum. This is a relatively safe and easy-to-learn method that avoids the perioperative complications associated with the conventional method.

使用超声和常规截骨术去除黄韧带胸骨化（TOLF） 的椎板切除术

Thoracic ossification of the ligamentum flavum (TOLF) is a common cause of progressive thoracic myelopathy. TOLF is typically treated with surgical ...

保留自主呼吸的视频辅助胸腔镜手术的非插管方案

Non-Intubated Video-Assisted Thoracoscopic Surgery

Double-lumen intubation under general anesthesia is currently the most commonly performed intubation technique for pneumonectomy, wedge resection of the lung, and lobectomy. However, there is a high incidence of pulmonary complications arising from general anesthesia with tracheal intubation. Non-intubation with the preservation of voluntary breathing is an alternative to anesthesia. Non-intubation procedures minimize the adverse effects of tracheal intubation and general anesthesia, such as intubation-related airway trauma, ventilation-induced lung injury, residual neuromuscular blockade, and post-operative nausea and vomiting. However, the steps for non-intubation procedures are not detailed in many studies. Here, we present a concise non-intubated protocol for the performance of video-assisted thoracoscopic surgery with preserved autonomic breathing. This article identifies the conditions necessary to convert from non-intubated to intubated anesthesia and also discusses the advantages and limitations of non-intubated anesthesia. In this work, this intervention was performed on 58 patients. In addition, the results of a retrospective study are presented. Compared with intubated general anesthesia, patients in the non-intubated video-assisted thoracic surgery group had lower rates of post-operative pulmonary complications, shorter operative times, less intraoperative blood loss, shorter PACU stays, a lower number of days to chest drain removal, less post-operative drainage, and shorter hospital stays.

作者聚焦: 一种具有多模式镇痛和七氟烷吸入麻醉的非插管视频辅助胸腔镜手术 

Here, we present a non-intubated protocol for performing video-assisted thoracoscopic surgery with preserved autonomic breathing.

非插管视频辅助胸腔镜手术

Double-lumen intubation under general anesthesia is currently the most commonly performed intubation technique for pneumonectomy, wedge resection of the ...

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Currently, the common approaches to thyroid surgery include conventional thyroidectomy, bilateral axillo-breast, axillary, retroauricular, and oral vestibule approaches. Essentially, various approaches to thyroid surgery only move the traditional surgical incision to a more concealed position but still leave scars on the body surface. Among them, thyroid surgery via the oral vestibule approach can obtain the best cosmetic outcome through the shortest natural cavity. However, in the early time, thyroid surgery via the oral vestibule approach usually requires three incisions in the mouth and one axillary incision. We have introduced a robotic surgical system into thyroidectomy via the oral vestibule approach and successfully completed total thyroidectomy and bilateral central lymph node dissection. During the operation, only three incisions were made at the oral vestibule without an axillary incision. This article aims to present the unique three-port method of robotic thyroidectomy via oral vestibule for the treatment of patients with papillary thyroid cancer.

The transoral robotic total thyroidectomy and bilateral central regional lymph node dissection using three ports without axillary incision are feasible and safe for early-stage papillary thyroid carcinoma. Here we present the operative techniques of this operation.

经口机器人甲状腺全切除术和双侧中央区域淋巴结清扫术治疗甲状腺状癌

Currently, the common approaches to thyroid surgery include conventional thyroidectomy, bilateral axillo-breast, axillary, retroauricular, and oral ...

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

For patients with early, low-risk papillary thyroid carcinoma, an increasing number are opting for endoscopic thyroid surgery due to its ability to achieve favorable therapeutic outcomes while maintaining excellent cosmetic results. Among the available endoscopic procedures, the Gasless Endoscopic Thyroidectomy Trans-axillary Approach (GETTA) has gained popularity among surgeons. This is attributed to its straightforward cavity construction, spacious operating area, precise visual field exposure, and manageable learning curve. However, few studies have provided detailed descriptions of the specific surgical steps involved in GETTA. Drawing from a synthesis of existing literature and our own clinical expertise, we present a comprehensive outline of the GETTA procedure. This process can be categorized into five distinct stages: positioning and incision planning; establishment of surgical cavities; identification and protection of the recurrent laryngeal nerve, inferior parathyroid gland, and central neck dissection; localization and preservation of the superior laryngeal nerve, superior parathyroid gland, and dissection of the thyroid's superior pole; transection of the thyroid isthmus followed by en bloc resection of the thyroid gland and central neck lymph nodes. The five-step approach of GETTA is easy to learn and can be adapted for resecting both benign and malignant thyroid and parathyroid diseases.

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

This protocol presents the procedure for conducting thyroidectomy using the gasless endoscopic thyroidectomy trans-axillary approach (GETTA).

通过经腋窝入路进行无气内窥镜甲状腺切除术

For patients with early, low-risk papillary thyroid carcinoma, an increasing number are opting for endoscopic thyroid surgery due to its ability to ...

Removal of Subcostal Specimen After Complete Portal Robotic Lobectomy

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

The Completely Portal Robotic Lobectomy (CPRL-4) technique is increasingly favored for lobectomy procedures due to its advancements over traditional robot-assisted lobectomy (RAL). CPRL-4 integrates a fourth robotic arm and CO2 insufflation, resulting in superior visualization within the intrathoracic cavity owing to enhanced lung deflation. While CPRL-4 effectively achieves pulmonary resection, extracting specimens typically necessitates an intercostal utility thoracotomy, which may pose risks. To address potential damage associated with this method, we introduced a subcostal trans-diaphragmatic access port during resection, later enlarging it for specimen removal post-lobectomy. This study evaluated the efficacy and feasibility of this subcostal trans-diaphragmatic specimen removal approach following CPRL-4 procedures for pulmonary malignancies, all performed by a single surgical team. The findings suggest that subcostal specimen removal post-CPRL-4 offers several advantages, including reduced risk of thoracotomy-related complications, making it a practical, feasible, and safe method. This innovation has the potential to improve outcomes and patient care in pulmonary malignancy surgeries significantly.

This protocol describes the removal of lung specimens following a completely portal robotic lobectomy. Determining the optimal location for specimen extraction is a pertinent question, as both intercostal and subcostal routes can serve as potential extraction paths following robotic or video-thoracoscopic lobectomy. We choose subcostal lung specimen removal over intercostal removal.

The Completely Portal Robotic Lobectomy (CPRL-4) technique is increasingly favored for lobectomy procedures due to its advancements over traditional ...

Improved Thoracoscopic-Assisted Surgery for the Treatment of Metastatic Thoracic Vertebral Tumors

The significant progress made in the diagnosis and treatment of malignant tumors has led to improved patient survival rates. However, the metastatic spread of these tumors to the thoracic vertebrae remains a significant challenge, often resulting in bone-related adverse events, such as pathological fractures and severe complications. To address this issue, a refined multidisciplinary approach has been explored, which utilizes thoracoscopic techniques for tumor resection and spinal interventions. Thoracoscopic techniques offer a minimally invasive alternative to traditional open surgical methods, aiming to reduce the overall trauma experienced by patients. By leveraging the advantages of thoracoscopy, clinicians can effectively resect metastatic tumors within the thoracic vertebrae while minimizing the impact on surrounding tissues and structures. This approach, combined with targeted spinal interventions, has the potential to improve patient outcomes and quality of life by mitigating the debilitating effects of pathological fractures and other complications associated with metastatic bone disease. The implementation of this multidisciplinary strategy, incorporating thoracoscopic tumor resection and spinal interventions, represents a promising avenue for the management of metastatic tumors within the thoracic vertebrae. Further research and clinical evaluation are necessary to fully elucidate the long-term benefits and establish the optimal treatment protocols for this patient population, ultimately enhancing the care and outcomes for individuals afflicted by this challenging condition.

Here, we present a protocol to demonstrate an improved thoracoscopic-assisted surgery for the treatment of metastatic thoracic vertebral tumors.

改进的胸腔镜辅助手术治疗转移性胸椎肿瘤

The significant progress made in the diagnosis and treatment of malignant tumors has led to improved patient survival rates. However, the metastatic ...

经腋窝第一肋骨切除术治疗胸廓出口综合征

摘要

探索更多视频

右前小切口主动脉瓣置换术的技术及患者选择标准

低成本单端口（LoCoSP）设备，用于微创性跨侵入性食管切除术中的内脏方法

使用超声和常规截骨术去除黄韧带胸骨化（TOLF）的椎板切除术

非插管视频辅助胸腔镜手术

非插管视频辅助胸腔镜手术

非插管视频辅助胸腔镜手术

经口机器人甲状腺全切除术和双侧中央区域淋巴结清扫术治疗甲状腺状癌

通过经腋窝入路进行无气内窥镜甲状腺切除术

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

改进的胸腔镜辅助手术治疗转移性胸椎肿瘤

经腋窝第一肋骨切除术治疗胸廓出口综合征

摘要

探索更多视频

右前小切口主动脉瓣置换术的技术及患者选择标准

低成本单端口 （LoCoSP） 设备，用于微创性跨侵入性食管切除术中的内脏方法

使用超声和常规截骨术去除黄韧带胸骨化（TOLF） 的椎板切除术

非插管视频辅助胸腔镜手术

非插管视频辅助胸腔镜手术

非插管视频辅助胸腔镜手术

经口机器人甲状腺全切除术和双侧中央区域淋巴结清扫术治疗甲状腺状癌

通过经腋窝入路进行无气内窥镜甲状腺切除术

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

改进的胸腔镜辅助手术治疗转移性胸椎肿瘤

低成本单端口（LoCoSP）设备，用于微创性跨侵入性食管切除术中的内脏方法

使用超声和常规截骨术去除黄韧带胸骨化（TOLF）的椎板切除术