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节段性支气管袖状切除术:保留所有肺实质用于良性/低级别肿瘤。

Segmental bronchial sleeve resection: preserving all lung parenchyma for benign/low-grade neoplasms.

机构信息

Department of Thoracic Surgery, Ankara University School of Medicine, Ankara, Turkey.

出版信息

Ann Thorac Surg. 2010 Jun;89(6):1737-43. doi: 10.1016/j.athoracsur.2010.02.060.

Abstract

BACKGROUND

Bronchoplastic techniques are used commonly for the surgical treatment of benign or low-grade malignant neoplasms as a means of sparing healthy lung parenchyma. Because of technical difficulties, however, standard lobectomy or segmentectomy procedures are performed for the neoplasms localized in distally located tumors. We present the clinical and surgical data of 12 patients who underwent a unique surgical procedure, called by the authors of this article "segmental bronchial sleeve resection," without any pulmonary resection.

METHODS

Twelve patients with benign or low-grade malignant neoplasms who underwent segmental bronchial sleeve resection to totally preserve lung parenchyma between the years 1979 and 2008 were included in the study. Data were gathered from patient records retrospectively.

RESULTS

The postoperative course was uneventful for 10 patients. One of the remaining 2 patients underwent rethoracotomy because of hemorrhage, and tracheostomy was performed for the other patient because of persistent atelectasis. There was no mortality for any of the patients.

CONCLUSIONS

Segmental bronchial sleeve resection is complex in technique and may have an increased risk of complications compared to a standard sleeve resection, but it is an effective and safe bronchoplastic technique for selected patients with benign or low-grade malignant bronchial tumors when performed carefully by an experienced surgeon.

摘要

背景

支气管成形术常用于良性或低级别恶性肿瘤的外科治疗,目的是保留健康的肺实质。然而,由于技术上的困难,对于位于远端肿瘤的肿瘤,标准的肺叶切除术或节段切除术仍被采用。我们报告了 12 例接受独特手术的患者的临床和手术数据,该手术由本文作者命名为“节段性支气管袖状切除术”,无需进行任何肺切除术。

方法

本研究纳入了 1979 年至 2008 年间接受节段性支气管袖状切除术以完全保留肺实质的 12 例良性或低级别恶性肿瘤患者。数据从患者病历中回顾性收集。

结果

10 例患者的术后过程顺利。其余 2 例患者中,1 例因出血再次开胸,1 例因持续肺不张行气管切开术。所有患者均无死亡。

结论

与标准袖状切除术相比,节段性支气管袖状切除术技术复杂,并发症风险可能增加,但对于经验丰富的外科医生精心操作的良性或低级别恶性支气管肿瘤的选定患者,这是一种有效且安全的支气管成形技术。

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