Department of Thoracic Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 814-0180, Japan.
Surg Today. 2011 Sep;41(9):1302-5. doi: 10.1007/s00595-010-4429-3. Epub 2011 Aug 26.
Bronchial complications owing to airway anastomosis still remain a cause of morbidity and mortality following lung transplantation, and bronchial stenosis is the most common manifestation. Current treatment strategies include endoscopic balloon dilation, laser ablation, and stent insertion. Although a variety of stent types are currently available, it is unclear as to which type of prosthesis is most suitable for post-transplant bronchial complications with regard to the primary effects and long-term outcomes. We herein discuss a case of stenosis of the right bronchial anastomosis in a patient who underwent right single lung transplantation for idiopathic pulmonary fibrosis. This complication was successfully treated with the placement of a modified Dumon Y-stent. The stent was removed 2 months after insertion, and the patient has subsequently maintained an adequate airway caliber. Computed tomography, especially the sagittal section through the chest, is useful for detecting bronchial stenosis and monitoring the healing of this condition.
支气管吻合口并发症仍然是肺移植术后发病率和死亡率的一个原因,其中支气管狭窄是最常见的表现。目前的治疗策略包括内镜球囊扩张、激光消融和支架置入。尽管目前有多种支架类型,但对于移植后支气管并发症,哪种类型的假体在主要效果和长期结果方面最适合,目前尚不清楚。我们在此讨论了一例特发性肺纤维化患者行右单肺移植术后右支气管吻合口狭窄的病例。该并发症采用改良 Dumon Y 型支架置入成功治疗。支架置入 2 个月后取出,此后患者保持了足够的气道直径。计算机断层扫描,特别是胸部矢状位,有助于发现支气管狭窄并监测其愈合情况。