Tapias Luis F, Ott Harald C, Mathisen Douglas J
Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Blake 15, Boston, MA 02114, USA.
Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Blake 15, Boston, MA 02114, USA.
Thorac Surg Clin. 2015 Nov;25(4):435-47. doi: 10.1016/j.thorsurg.2015.07.003. Epub 2015 Sep 8.
Pulmonary resections with concomitant circumferential airway resection and resection and reconstruction of carina and main stem bronchi remain challenging operations in thoracic surgery. Anastomotic complications range from mucosal sloughing and formation of granulation tissue, anastomotic ischemia promoting scar formation and stricture, to anastomotic breakdown leading to bronchopleural or bronchovascular fistulae or complete dehiscence. Careful attention to patient selection and technical detail results in acceptable morbidity and mortality as well as good long-term survival. In this article, we focus on the technical details of the procedures, how to avoid complications and most importantly how to manage complications when they occur.
同期进行环形气道切除以及隆突和主支气管切除与重建的肺切除术,仍然是胸外科中具有挑战性的手术。吻合口并发症范围从粘膜脱落和肉芽组织形成、促进瘢痕形成和狭窄的吻合口缺血,到导致支气管胸膜瘘或支气管血管瘘或完全裂开的吻合口破裂。仔细关注患者选择和技术细节可带来可接受的发病率和死亡率以及良好的长期生存率。在本文中,我们重点关注手术的技术细节、如何避免并发症,以及最重要的是当并发症发生时如何进行处理。