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[原发性肺癌突入右主支气管,经内镜钕钇铝石榴石(Nd-YAG)激光成功治疗]

[Primary lung cancer protruding into right main bronchus, successfully treated with endoscopic neodymium yttrium aluminum garnet (Nd-YAG) laser].

作者信息

Kawano R, Hino H, Hoshino T, Yokota T, Ikeda S, Hata E

机构信息

Surgical Department of Respiratory Center, Mitsui Memorial Hospital, Tokyo, Japan.

出版信息

Kyobu Geka. 2009 Aug;62(9):807-11.

Abstract

Endoscopic neodymium yttrium aluminum garnet (Nd-YAG) laser treatment for endobronchial obstruction originating from the tumor provides a favorable outcome. A 67-year-old male patient with a chief complaint of cough and sputum had a primary lung cancer (squamous cell carcinoma) in the upper lobe of the right lung. The tumor projected into the right main bronchus through the upper lobe bronchus, which completely occluded the lumen of right main bronchus. Middle and lower lobes showed an obstructive pneumonia caused by its obstruction. Firstly, endoscopic Nd-YAG laser treatment for patency of right main bronchus was preoperatively performed with an aim to early improvement of obstructive pneumonia Since the inflammatory findings showed markedly improvement, a right upper sleeve lobectomy could safely be performed. The resected specimen of the tumor in the right upper lobe proved to be a case of complete resection with pathological stage IIIA (T3N1M0). When preoperative lung cancer patient has an obstructive pneumonia causing by the protruding tumor into the central airway, a patency treatment of bronchial airway using endoscopic Nd-YAG laser may lead to decrease a perioperative risk.

摘要

内镜下钕钇铝石榴石(Nd-YAG)激光治疗源于肿瘤的支气管内阻塞可取得良好效果。一名67岁男性患者,以咳嗽、咳痰为主诉,右肺上叶患有原发性肺癌(鳞状细胞癌)。肿瘤通过上叶支气管突入右主支气管,完全阻塞了右主支气管腔。中叶和下叶因阻塞出现阻塞性肺炎。首先,术前进行内镜下Nd-YAG激光治疗以打通右主支气管,目的是早期改善阻塞性肺炎。由于炎症表现明显改善,遂安全地实施了右上叶袖状肺叶切除术。右上叶肿瘤切除标本病理分期为ⅢA期(T3N1M0),证实为完全切除。当术前肺癌患者因肿瘤突入中央气道导致阻塞性肺炎时,使用内镜Nd-YAG激光对支气管气道进行通畅治疗可能会降低围手术期风险。

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