胸腔镜下后/后外基底段(S10/S9 + 10)切除术 手术入路研究进展

Research Progress on Surgical Approaches for Thoracoscopic Posterior/Lateral Posterior Basal Segment (S10/S9 + 10) Resection

摘要: 肺癌是全球第一大癌症，肺段切除术在遵循肿瘤学基本原则的同时保留更多肺功能，越来越被广大医患认可且有望成为早期肺癌的标准术式。胸腔镜下后/后外侧基底段(S9/S9 + 10)切除术由于其解剖位置的特殊性，解剖变异的多变性及其段间平面的复杂性，使之成为肺段切除中最困难的术式之一，因此选择合适的手术入路至关重要。本综述简述临床上常用的叶间裂入路、下肺韧带入路、后侧入路、叶间裂联合下肺韧带入路等手术入路途径的操作要点、优劣势及注意事项，为后/后外侧基底段切除术手术入路的选择提供参考，提高手术的安全性，降低手术并发症的发生率。

Abstract: Lung cancer is the leading cause of cancer-related deaths worldwide, and segmentectomy, which preserves more pulmonary function while adhering to oncological principles, is increasingly recognized by medical professionals and patients as a potential standard treatment for early-stage lung cancer. Thoracoscopic posterior/lateral basal segmentectomy (S9/S9 + 10) is one of the most challenging procedures in pulmonary segmentectomy due to its unique anatomical location, high variability in anatomical variations, and complexity of the intersegmental planes, making the selection of appropriate surgical approach critical. This review summarizes the key operative points, advantages, disadvantages, and precautions of commonly used surgical approaches in clinical practice, including the interlobar fissure approach, pulmonary ligament approach, posterior approach, and combined interlobar fissure and pulmonary ligament approach, providing valuable guidance for selecting the optimal surgical approach for posterior/lateral basal segmentectomy, thereby enhancing surgical safety and reducing the incidence of postoperative complications.