左肺切除术后体外膜肺氧合辅助食管切除术
ECMO-assisted esophagectomy after left pneumonectomy.
作者信息
Xu Hai Chao, Ye Peng, Bao Fei Chao, Pan Hui, Yang Yun Hai, Wang Lu Ming, Wang Zhi Tian, Li Zhou Bin, He Zhe Hao, Han Wei Li, Wang Yong Qing, Hu Jian
机构信息
Department of Thoracic Surgery, First Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
出版信息
Int J Artif Organs. 2013 Apr;36(4):259-62. doi: 10.5301/IJAO.5000198. Epub 2013 Feb 13.
BACKGROUND
Esophagectomy after pneumonectomy has been rarely reported, mainly due to the technical difficulty in performing this surgical approach. Conventional intubation to the contralateral respiratory passage is technically challenging, while the homolateral respiratory tract is absent, making oxygenation impossible.
METHODS
To overcome this problem, we used venoarterial (VA) extracorporeal membrane oxygenation (ECMO) which can help achieve gas exchange despite the collapsed lung and provide a clear unobstructed surgical field for esophagectomy.
RESULTS
We obtained satisfactory outcomes with VA ECMO in our treated patient.
CONCLUSIONS
This technique may be an excellent option for the treatment of complex situations such as esophagectomy after pneumonectomy.
背景
肺切除术后行食管切除术的报道很少，主要是因为实施这种手术方式存在技术难度。常规插管至对侧呼吸道在技术上具有挑战性，而同侧呼吸道不存在，导致无法进行氧合。
方法
为克服这一问题，我们使用了静脉-动脉（VA）体外膜肺氧合（ECMO），它有助于在肺萎陷的情况下实现气体交换，并为食管切除术提供清晰无阻碍的手术视野。
结果
我们治疗的患者使用VA ECMO取得了满意的效果。
结论
对于肺切除术后食管切除术等复杂情况的治疗，该技术可能是一个极佳的选择。
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