Rus O, Motaş C, Motaş N, Achim D, Horvat T
Chirurgia (Bucur). 2014 Jul-Aug;109(4):455-60.
Bronchial resections are surgical procedures in which bronchial continuity is interrupted, followed by reconstruction of resected ends through terminal anastomosis or various forms of plastic procedures. The purpose of these interventions is to preserve functional lung parenchyma. These procedures are indicated in tumors with central location as an alternative to pneumonectomies, serving to preserve maximum functional lung parenchyma.
We considered bronchoanastomotic and bronchoplastic procedures performed in our clinic over the period 2000-2009, for malignancy. There were 52 bronchoanastomotic resections and 9 bronchoplastic resections of which we analysed 40 bronchoanastomotic resections and 4 bronchoplastic resections (44 cases) ± associated resection. We excluded cases with non-malignant pathology or those with incomplete data at the beginning of the study.
The importance of the main factors involved in relation with survival was calculated. We considered the type of surgery performed, histological type, TNM stage, and characteristics of the study group (age, sex). We found statistically significant correlations between survival and histopathology of malignancy with a better survival for lung carcinoids, especially for typical carcinoid tumors. TNM stage did not significantly influence survival, but N2 nodal involvement,according to the statistics, shows a poor prognosis. Age is another statistical significant factor correlated with post operative life expectancy, patients over 65 years old having a worse postoperative survival.
In the corresponding lung malignant pathology, bronchoanastomotic bronchoplastic resections are indicated,but one must take into account the patient's age before submission to surgery, the histopathologic type and N2 nodal involvement.
支气管切除术是一种手术操作,在此过程中支气管连续性被中断,随后通过端端吻合或各种形式的整形手术重建切除端。这些干预措施的目的是保留功能性肺实质。这些手术适用于中央型肿瘤,作为全肺切除术的替代方法,以最大程度地保留功能性肺实质。
我们回顾了2000年至2009年期间在我们诊所进行的针对恶性肿瘤的支气管吻合术和支气管成形术。共有52例支气管吻合切除术和9例支气管成形切除术,其中我们分析了40例支气管吻合切除术和4例支气管成形切除术(共44例)及相关切除术。我们排除了非恶性病理或研究开始时数据不完整的病例。
计算了与生存相关的主要因素的重要性。我们考虑了所进行的手术类型、组织学类型、TNM分期以及研究组的特征(年龄、性别)。我们发现生存与恶性肿瘤的组织病理学之间存在统计学上的显著相关性,肺类癌尤其是典型类癌肿瘤的生存率更高。TNM分期对生存没有显著影响,但根据统计,N2淋巴结受累显示预后不良。年龄是另一个与术后预期寿命相关的统计学显著因素,65岁以上的患者术后生存率较差。
在相应的肺部恶性病理中,适合进行支气管吻合术和支气管成形术切除,但在进行手术前必须考虑患者的年龄、组织病理学类型和N2淋巴结受累情况。