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[1例原发性气管腺样囊性癌行根治性手术切除]

[A case of primary tracheal adenoid cystic carcinoma performed curative surgical resection].

作者信息

Kondo D, Imaizumi M, Ojika T, Sakakibara M, Uchida Y, Abe T

机构信息

Department of Thoracic Surgery, Nagoya University School of Medicine, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1990 Apr;38(4):672-6.

PMID:2165115
Abstract

A 67-year-old woman who was diagnosed as a relative early primary tracheal adenoid cystic carcinoma by preoperative examination underwent surgical resection. The histopathological extension of this carcinoma into the tracheal wall was much greater than was suggested before operation and 6 tracheal rings was curatively resected circumferentially. Median sternotomy and transection of the left brachiocephalic vein facilitated access to the trachea. To resect the extensive segment of the trachea, the right pulmonary ligament and hilum were mobilized. Additionally Dedo's laryngeal release was performed to lessen the tension at the anastomosis. Then the flap of the pleura and adipose tissue with the right internal mammary artery and vein was wrapped around the anastomosis for revascularization and protection of brachiocephalic artery. The postoperative course was not eventful. The postoperative dysphagia by Dedo's laryngeal release was mild and resolved within 7 days after operation. And the postoperative mammary arteriography showed the vessels around the anastomosis. This wrapping procedure is easy and does not need a laparotomy. So we think it is beneficial for prevention against postoperative complications of tracheoplasty.

摘要

一名67岁女性,术前检查诊断为相对早期的原发性气管腺样囊性癌,接受了手术切除。该癌向气管壁的组织病理学浸润程度比术前提示的要大得多,遂环形根治性切除6个气管环。正中胸骨切开术及切断左头臂静脉有助于暴露气管。为切除气管的广泛节段,游离了右肺韧带和肺门。此外,进行了德多氏喉松解术以减轻吻合口处的张力。然后将带有右乳内动脉和静脉的胸膜及脂肪组织瓣包裹在吻合口周围,以实现血管重建并保护头臂动脉。术后病程平稳。德多氏喉松解术导致的术后吞咽困难较轻,术后7天内缓解。术后乳腺动脉造影显示了吻合口周围的血管。这种包裹手术操作简便,无需开腹手术。因此,我们认为它有利于预防气管成形术后的并发症。

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