縦隔・胸壁腫瘍に対するロボット支援下手術―非定型アプローチ方法

Robot-assisted Thoracic Surgery for Mediastinal and Chest Wall Tumors：Atypical Surgical Approaches by the Tumor Localization

縦隔腫瘍ならびに胸壁腫瘍に対する手術では，腫瘍の発生部位や大きさ，周囲臓器への浸潤の有無などにより，さまざまなアプローチ方法が要求される1～5）．昨今低侵襲手術が普及しているが，手術支援ロボットを用いた手術に関してはポート配置や手術手順について施設間の差異も多く，いまだ発展途上といえる．本稿では，当施設で縦隔腫瘍ならびに胸壁腫瘍に対しロボット支援下での非定型的なアプローチ方法を要した症例に関して，文献的考察を加えて報告する．

Surgery for mediastinal and chest wall tumors requires various approaches, including open and thoracoscopic, depending on the size and localization of the tumor. While robotic surgery for anterior mediastinal tumors has become a standardized approach, the approaches for tumors of the superior, middle, and posterior mediastinum, in particular, have not been generalized. Our institution introduced robotic surgery in 2017 and has performed 785 robot-assisted surgeries until November 2022. In this report, we describe our clinical experience with robotic surgery for mediastinal tumors, which required an atypical approach, as well as a case of hybrid robot-assisted extended surgery combined with an open chest procedure for lung cancer with chest wall invasion.