Miura M, Nakame T, Itoh Y, Aikawa K, Isogami K, Ohkuda K
Department of Cardiovascular Surgery, Semine Hospital, Miyagi, Japan.
Kyobu Geka. 2000 Oct;53(11):963-5.
Surgical management for simultaneous pulmonary resection and cardiac surgery remains controversial. We report a case of coexisting lung carcinoma and angina pectoris who was managed successfully with a concomitant operation via the left anterolateral thoracotomy through the fourth intercostal space. After left lower lobectomy, left anterior descending and distal circumflex arteries were anastomosed with composite left internal thoracic and radial artery grafts without use of cardiopulmonary bypass. Both less invasive CABG and curative resection of lung carcinoma were achieved with these procedures.
同期肺切除与心脏手术的外科治疗仍存在争议。我们报告一例同时患有肺癌和心绞痛的患者,通过经第四肋间的左前外侧开胸术进行同期手术成功治疗。左肺下叶切除术后,在未使用体外循环的情况下,将左前降支和旋支远端与左胸廓内动脉和桡动脉复合移植物进行吻合。通过这些手术既实现了创伤较小的冠状动脉旁路移植术(CABG),又实现了肺癌的根治性切除。