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[同时行肺切除术和血管内修复术治疗合并原发性肺癌和动脉瘤的患者]

[Simultaneous pulmonary resection and endovascular repair for patients with coexisting primary lung cancer and aneurysm].

作者信息

Koike Terumoto, Sato Hiroki, Sato Seijiro, Okamoto Takeshi, Hashimoto Takehisa, Hanzawa Kazuhiko, Tsuchida Masanori

机构信息

Division of Thoracic and Cardiovascular Surgery, Niigata University School of Medical and Dental Sciences, Niigata, Japan.

出版信息

Kyobu Geka. 2015 Apr;68(4):293-7.

Abstract

The surgical strategy for coexisting lung cancer and aneurysm is controversial owing to the risk of aneurysm rupture during the perioperative period of pulmonary resection. We performed simultaneous pulmonary resection and endovascular repair in 2 patients with coexisting lung cancer and aneurysm. Case 1:A 74-year-old man presented at our hospital with cT2aN0M0 lung cancer and a 5.0 cm abdominal aortic aneurysm. Because computed tomography indicated the possibility of advanced lung cancer, we decided to perform simultaneous surgery for lung cancer and the aneurysm. Under general anesthesia, endovascular aneurysm repair was performed before right lower lobectomy with lymphadenectomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 12. Case 2:A 72-year-old man presented at our hospital with cT2aN1M0 lung cancer, a 5.0 cm left internal iliac artery aneurysm, and right renal cell carcinoma( RCC). Because the lung cancer was advanced and the patients needed following surgical treatment for RCC, we decided to perform simultaneous surgery for lung cancer and the aneurysm. Under general anesthesia, endovascular aneurysm repair was performed before right upper lobectomy with lymphadenectomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 11.

摘要

由于在肺切除围手术期存在动脉瘤破裂的风险,对于同时存在肺癌和动脉瘤的手术策略存在争议。我们对2例同时患有肺癌和动脉瘤的患者进行了同期肺切除和血管内修复术。病例1:一名74岁男性因cT2aN0M0期肺癌和一个5.0 cm的腹主动脉瘤到我院就诊。由于计算机断层扫描显示可能为晚期肺癌,我们决定同时对肺癌和动脉瘤进行手术。在全身麻醉下,先进行血管内动脉瘤修复术,然后行右下肺叶切除并淋巴结清扫术。术后过程顺利,患者于术后第12天出院。病例2:一名72岁男性因cT2aN1M0期肺癌、一个5.0 cm的左髂内动脉瘤和右肾细胞癌(RCC)到我院就诊。由于肺癌已属晚期且患者需要对肾细胞癌进行后续手术治疗,我们决定同时对肺癌和动脉瘤进行手术。在全身麻醉下,先进行血管内动脉瘤修复术,然后行右上肺叶切除并淋巴结清扫术。术后过程顺利,患者于术后第11天出院。

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