Bilateral anterior chest incision

For pericardial stripping, extracorporeal circulation surgery and anterior mediastinal tumor resection. Treatment of diseases: mediastinal tumor Indication For pericardial stripping, extracorporeal circulation surgery and anterior mediastinal tumor resection. Contraindications 1. The blood coagulation mechanism has serious obstacles. 2. Hypertension, diabetes, and some bleeding-prone diseases. Preoperative preparation 1. According to general nursing routine before general surgery. 2. Guide lung function training to prevent colds and prevent postoperative pulmonary complications. 3, according to the surgical site for skin preparation (1) posterior external incision: the median line of the anterior chest to the posterior spine line, including the underarm, from the horizontal line of the clavicle to the xiphoid. (2) Median incision: the posterior chest to the posterior line to the right posterior line, including bilateral underarms. (3) Three incisions of the esophagus: left neck, right chest (same posterior incision), abdomen (including umbilicus, perineum). (4) chest and abdomen combined incision: left chest (same posterior incision), left upper abdomen. 4. After the patient is sent to the operating room, prepare the monitoring instruments and routine rescue items. Surgical procedure 1. Between the bilateral anterior tibia, the male is along the fourth intercostal space, and the female is traversing the sternum along the breast (Fig. 1). 2. Cut the pectoralis major and the pectoralis minor muscle, and cut the intercostal muscle from the 4th intercostal space into the pleural cavity. 3. Reveal the blood vessels in the thoracic cavity on the left and right sides of the sternal border, clamp, cut and ligation the upper and lower ends (Fig. 2), and cross the sternum with a wire saw (Fig. 3). 4. Open the incision with a chest opener to reveal the anterior mediastinum. 5. Suture incision: closed drainage was placed in both pleural cavities. The sternum was sutured with stainless steel wire, and the bilateral incision was sutured with a 3-needle 10 wire around the upper and lower ribs (Fig. 4), and the incision was sutured layer by layer. complication Incision infection.