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两例原发性肺癌侵犯隆突的楔形肺切除术病例

[Two cases of wedge pneumonectomy in primary lung cancer involved into carina].

作者信息

Hoshi E, Kobayashi M, Satoh T, Aoyama K, Yuki Y, Fukazawa M, Oizumi H, Gotoh S, Fujishima T, Washio M

机构信息

Second Department of Surgery, Yamagata University School of Medicine.

出版信息

Kyobu Geka. 1990 Mar;43(3):226-30.

PMID:2319722
Abstract

Right wedge pneumonectomy was performed on two cases of primary lung cancer involved into carina. A 59-year-old male involved with primary lung cancer was found with bloody sputum. Preoperative data confirmed as the superficial spread type of squamous cell carcinoma in carinal lesion and tumor was resectable with wedge pneumonectomy. In the second case, abnormal shadow was pointed out on chest X-ray film of a 61-year-old male patient. Preoperative examination defined as primary lung cancer of rt-S6 with subcarinal lymph node metastasis. The operation indicated wedge pneumonectomy with patch plasty using the wall of right main bronchus. Although wedge pneumonectomy is not common compared to sleeve pneumonectomy, if available this procedure is technically easier and post-operative management may be more successful. Wedge pneumonectomy limits resectable area, because the continuation of tracheo-bronchial wall must be remained in part. Therefore, the indication of this procedure for surgical treatment of lung cancer is limited. However, when this procedure indicates to selected case with limited lesion of carina, this may be an useful procedure as surgical treatment of primary lung cancer.

摘要

对2例累及隆突的原发性肺癌患者实施了右肺楔形切除术。1例59岁男性原发性肺癌患者出现咯血痰。术前资料证实隆突病变为浅表扩散型鳞状细胞癌,肿瘤可通过楔形肺切除术切除。第2例为1名61岁男性患者,胸部X线片显示异常阴影。术前检查确定为右肺下叶S6原发性肺癌伴隆突下淋巴结转移。手术方式为右肺楔形切除术并使用右主支气管壁进行补片成形术。虽然与袖状肺叶切除术相比,楔形肺叶切除术并不常见,但如果可行,该手术在技术上更简单,术后管理可能更成功。楔形肺叶切除术限制了可切除区域,因为气管支气管壁的连续性必须部分保留。因此,该手术用于肺癌外科治疗的适应证有限。然而,当该手术适用于隆突病变局限的特定病例时,它可能是原发性肺癌外科治疗的一种有用方法。

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