一种治疗肋间疝和修复肋缘破裂的新技术的演变
The evolution of a novel technique for treatment of intercostal hernias and restoration of costal margin rupture.
作者
作者单位
- Department of Cardiothoracic Surgery, Royal Hobart Hospital, Hobart, Australia; Heart, Trauma & Sepsis Research Laboratory, Australian Institute of Tropical Health and Medicine, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia. Electronic address: rajiv.sharma@ths.tas.gov.au.
- Department of Cardiothoracic Surgery, Royal Hobart Hospital, Hobart, Australia.
摘要
中文
肋缘破裂（CMR），伴或不伴肋间疝（IH），常被漏诊。这导致了最近对全面和标准化分类的建议，旨在提高对这些损伤的怀疑指数。[1] 虽然已经发表了一些手术技术，但手术失败率仍然很高，最佳手术管理仍未明确。我们介绍了三名 IH 患者，其中 CMR 的诊断在外科治疗中起了关键作用。在第一例中，CMR 是在首次尝试治疗 IH 的手术失败后术后确定的。相反，在第二和第三例中，临床怀疑的增加导致早期诊断 CMR。所有三名患者均通过一种创新技术成功修复了 CMR，该技术使用钛棒压接到可旋转连接器上，安装在钛肋夹上。这些病例强调了早期识别和全面影像学及数字重建技术在检测 CMR 中的重要性。该手术技术可能是胸壁外科医生手术武器库中的一个有用补充。
English
Costal Margin Rupture (CMR), with or without Intercostal Hernia (IH), is often a missed diagnosis. This has led to recent recommendations for a comprehensive and standardised classification, aiming to generate a heightened index of suspicion for these injuries. [1] While some surgical techniques have been published, surgical failure rates remain high and optimal surgical management remains undefined. We present three patients with IH, where the diagnosis of CMR played a pivotal role in the surgical management. In the first case, the CMR was identified post-operatively after a first surgical attempt to treat the IH had failed. In contrast, increased clinical suspicion in the second and third cases led to early diagnosis of the CMR. All three patients underwent a successful repair of the CMR using an innovative technique with a titanium bar crimped to rotatable connectors mounted on titanium rib clips. These cases highlight the importance of early recognition and comprehensive imaging and digital reconstruction techniques in detecting CMR. The surgical technique might be a useful addition to the surgical armamentarium/repertoire of the chest wall surgeon.
分类与指标
- 研究类型
- 临床研究
- 病种
- 气胸·外伤·胸壁
- JCR 分区
- Q2
- 影响因子
- 2.4
- 新锐分区
- 3区