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血液透析患者非小细胞肺癌的电视辅助胸腔镜手术

Video-assisted thoracoscopic surgery for non-small cell lung cancer in patients on hemodialysis.

作者信息

Akiba Tadashi, Marushima Hideki, Hiramatsu Miwako, Matsudaira Hideki, Nakanishi Kozo, Takeyama Hiroshi, Kobayashi Susumu, Morikawa Toshiaki

机构信息

Department of Surgery, Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa, Chiba, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2010 Aug;16(1):40-4.

Abstract

There have been a few reports of pulmonary resection for lung cancer in patients on hemodialysis (HD), but no reports of video-assisted thoracoscopic surgery (VATS) in these patients have been submitted. We describe two patients on HD undergoing thoracoscopic resection for lung cancer. For the thoracoscopic operation, anatomies of the patients were confirmed by three-dimensional multidetector computed tomography (3D-MDCT). The first patient underwent a right lower lobectomy thoracoscopically, and the second patient underwent a resection of the superior segment of the right lower lobe thoracoscopically. They were discharged on postoperative days 10 and 4, respectively. A review of the literature reveals that morbidity and mortality for pulmonary resection on HD are 74% and 11%, respectively. Thoracoscopic operations for lung cancer patients on HD may minimize the operative invasiveness. Preoperative 3D-MDCT angiography was useful because it supports understanding of the patient's personal anatomy for VATS.

摘要

已有一些关于血液透析(HD)患者行肺癌肺切除术的报道,但尚未有这些患者行电视辅助胸腔镜手术(VATS)的报道。我们描述了两名接受HD治疗的患者行胸腔镜下肺癌切除术的情况。对于胸腔镜手术,通过三维多排螺旋计算机断层扫描(3D-MDCT)确认患者的解剖结构。第一例患者接受了胸腔镜下右下肺叶切除术,第二例患者接受了胸腔镜下右下叶上段切除术。他们分别在术后第10天和第4天出院。文献回顾显示,HD患者肺切除的发病率和死亡率分别为74%和11%。HD患者行胸腔镜手术治疗肺癌可将手术侵袭性降至最低。术前3D-MDCT血管造影很有用,因为它有助于了解患者的个体解剖结构以进行VATS。

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