Macherey S, Doerr F, Wahlers T, Hekmat K
Medizinische Fakultät, Universität zu Köln, Köln.
Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universität zu Köln, Köln.
Pneumologie. 2017 Jul;71(7):475-479. doi: 10.1055/s-0043-102534. Epub 2017 Mar 27.
This review presents laser resection as treatment option in pulmonary metastasectomy and summarizes the current evidence. Moreover, it includes the comparison of laser resection and common techniques used in lung metastasectomy. We performed a systematic literature research in Medline and the Cochrane library to detect case series and even randomized trials. All included studies underwent qualitative analysis. Laser metastasectomy is a safe procedure. Data regarding relevant clinical end points as hospitalization, duration of chest tube drainage and long-term survival are heterogeneous and still controversial. Laser enucleation decreases the resection volume. Therefore, it leads to a significant reduction of parenchymal loss. Survival rates after laser metastasectomy are equal to the outcome after resection using other techniques. Laser resection is a parenchyma-sparing method. Hence, it offers radical metastasectomy even in case of multiple pulmonary lesions or impaired lung capacity.
本综述介绍了激光切除作为肺转移瘤切除术的一种治疗选择，并总结了当前的证据。此外，还包括激光切除与肺转移瘤切除术中常用技术的比较。我们在Medline和Cochrane图书馆进行了系统的文献研究，以检索病例系列甚至随机试验。所有纳入的研究均进行了定性分析。激光转移瘤切除术是一种安全的手术。关于住院、胸管引流持续时间和长期生存等相关临床终点的数据存在异质性且仍有争议。激光摘除术可减少切除体积。因此，它能显著减少实质损失。激光转移瘤切除术后的生存率与使用其他技术切除后的结果相当。激光切除是一种保留实质的方法。因此，即使在存在多个肺部病变或肺功能受损的情况下，它也能提供根治性的转移瘤切除术。
