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活体肺叶移植供体肺叶切除相关并发症。

Complications related to lobectomy in living lobar lung transplant donors.

作者信息

Camargo Spencer Marcantônio, Camargo José de Jesus Peixoto, Schio Sadi Marcelo, Sánchez Leticia Beatriz, Felicetti José Carlos, Moreira José da Silva, Andrade Cristiano Feijó

机构信息

ISCMPA, Santa Casa Hospital at Porto Alegre - PortoAlegre, Brazil.

出版信息

J Bras Pneumol. 2008 May;34(5):256-63. doi: 10.1590/s1806-37132008000500003.

Abstract

OBJECTIVE

To evaluate post-operative complications in living lobar lung transplant donors.

METHODS

Between September of 1999 and May of 2005, lobectomies were performed in 32 healthy lung transplant donors for 16 recipients. The medical charts of these donors were retrospectively analyzed in order to determine the incidence of postoperative complications and alterations in pulmonary function after lobectomy.

RESULTS

Twenty-two donors (68.75%) presented no complications. Among the 10 donors presenting complications, the most frequently observed complication was pleural effusion, which occurred in 5 donors (15.6% of the sample). Red blood cell transfusion was necessary in 3 donors (9.3%), and 2 donors underwent a second surgical procedure due to hemothorax. One donor presented pneumothorax after chest tube removal, and one developed respiratory infection. There were two intra-operative complications (6.25%): one donor required bronchoplasty of the middle lobe; and another required lingular resection. No intra-operative mortality was observed. Post-operative pulmonary function tests demonstrated an average reduction of 20% in forced expiratory volume in one second (p < 000.1) compared to pre-operative values.

CONCLUSIONS

Lobectomy in living lung transplant donors presents high risk of post-operative complications and irreversible impairment of pulmonary function. Careful pre-operative evaluation is necessary in order to reduce the incidence of complications in living lobar lung transplant donors.

摘要

目的

评估活体肺叶移植供体的术后并发症。

方法

1999年9月至2005年5月期间,对32名健康的肺移植供体进行肺叶切除术,为16名受体提供肺源。对这些供体的病历进行回顾性分析,以确定肺叶切除术后并发症的发生率和肺功能的变化。

结果

22名供体(68.75%)未出现并发症。在出现并发症的10名供体中,最常见的并发症是胸腔积液,5名供体出现该并发症(占样本的15.6%)。3名供体(9.3%)需要输注红细胞,2名供体因血胸接受了二次手术。1名供体在拔除胸管后出现气胸,1名供体发生呼吸道感染。术中出现2例并发症(6.25%):1名供体需要对中叶进行支气管成形术;另1名供体需要切除舌叶。未观察到术中死亡情况。术后肺功能测试显示,与术前值相比,一秒用力呼气量平均降低了20%(p<0.001)。

结论

活体肺叶移植供体的肺叶切除术术后并发症风险高,且肺功能会出现不可逆损害。为降低活体肺叶移植供体的并发症发生率,术前进行仔细评估很有必要。

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