Erard A C, Monnier P, Spiliopoulos A, Nicod L
Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland.
Chest. 2001 Dec;120(6):2103-5. doi: 10.1378/chest.120.6.2103.
A 27-year-old patient with cystic fibrosis underwent a bilateral lung transplantation despite the presence of multiresistant Burkholderia cepacia. Postoperatively, the patient presented with bilateral bronchial necrosis. During the 14th week, his FEV(1) dropped to 2.5 L from a baseline level of 3.4 L. A subtotal occlusion of the right mainstem bronchus below the suture was noted. Using argon electrocoagulation, the right upper lobe bronchus, the intermediate bronchus, and the right middle lobe bronchus were reopened. During the period between weeks 20 and 42 post-transplantation, a recurrent stenosis required eight endoscopic interventions combining dilatation and stenting. During the 42nd week, dilatation followed by mitomycin C application stabilized the right lung function. This case report is the first to describe the effectiveness of the local application of mitomycin C to stop recurring extensive bronchial stenosis following bronchial necrosis secondary to lung transplantation.
一名27岁的囊性纤维化患者，尽管存在多重耐药的洋葱伯克霍尔德菌，仍接受了双侧肺移植。术后，患者出现双侧支气管坏死。在第14周时，他的第一秒用力呼气容积（FEV₁）从基线水平的3.4升降至2.5升。注意到缝合线下方的右主支气管出现部分闭塞。使用氩气电凝法，重新开通了右上叶支气管、中间支气管和右中叶支气管。在移植后第20周至42周期间，复发性狭窄需要8次结合扩张和支架置入的内镜干预。在第42周时，扩张后应用丝裂霉素C使右肺功能稳定。本病例报告首次描述了局部应用丝裂霉素C以阻止肺移植后继发支气管坏死所致反复广泛性支气管狭窄的有效性。
