Fu Xiangning, Zhang Ni, Sun Wei, Zhao Bo, Xu Qinzi
Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Scicence and Technology, Wuhan 430030, China.
J Huazhong Univ Sci Technolog Med Sci. 2007 Aug;27(4):454-6. doi: 10.1007/s11596-007-0427-0.
Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the "lobular bronchi" with main bronchi. Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.
支气管成形术扩展至肺段水平，观察多段手术治疗中央型非小细胞肺癌的效果。切除受累的小叶支气管及部分主支气管，采用5-0普理灵进行单层连续缝合，重建段支气管的隆突以形成小叶支气管。然后，用4-0普理灵进行单层连续缝合，将“小叶支气管”与主支气管吻合。我们的结果显示，15例支气管成形术均成功实施。肿瘤被完全切除，术后患者的肺功能得到显著改善。所有病例均未发生支气管胸膜瘘和吻合口狭窄。患者的生活质量明显提高。结论是，多段支气管成形术能够完全切除中央型非小细胞肺癌的肿瘤，并保留更多未受累的肺组织。该手术尤其适用于肺功能严重受损的患者，扩大了肺癌手术切除的适应证。
