Tsubochi Hiroyoshi, Kanai Yoshihiko, Tezuka Kenji, Watanabe Yasutaka, Koyama Shinichiro, Nakano Tomoyuki, Isogami Katsuhiko, Endo Shunsuke
Department of General Thoracic Surgery, Saitama Medical Center, Jichi Medical School, 1-847 Amanuma-cho, Saitama 330-8503, Japan.
Gen Thorac Cardiovasc Surg. 2011 Jul;59(7):515-7. doi: 10.1007/s11748-010-0717-5. Epub 2011 Jul 14.
Although extended sleeve lobectomy has been used as an alternative to pneumonectomy for the treatment of centrally located lung cancer, the validity of this surgical procedure is unclear in patients with peripheral lung cancer with interlobar lymph node metastasis invading the bronchus. We herein report four patients with peripheral lung cancer in the left lower lobe who underwent extended sleeve lobectomy consequent to interlobar lymph node metastasis. The tumor and metastasized lymph node was extirpated en bloc with division of the main bronchus and upper division bronchus, and those bronchi were anastomosed using the telescope method. All patients were doing well without recurrence. Extended sleeve lobectomy may be applicable to patients with peripheral lung cancer with interlobar lymph node metastasis invading the bronchus to avoid pneumonectomy.
尽管扩大袖式肺叶切除术已被用作全肺切除术的替代方法来治疗中央型肺癌，但对于伴有叶间淋巴结转移且侵犯支气管的周围型肺癌患者，这种手术方法的有效性尚不清楚。我们在此报告4例左肺下叶周围型肺癌患者，因叶间淋巴结转移而接受了扩大袖式肺叶切除术。肿瘤和转移淋巴结与主支气管和上叶支气管的分支一并整块切除，并用套入法对这些支气管进行吻合。所有患者情况良好，无复发。扩大袖式肺叶切除术可能适用于伴有叶间淋巴结转移且侵犯支气管的周围型肺癌患者，以避免进行全肺切除术。
