199943 Department of Visceral, Transplant and Thoracic Surgery Center of Operative Medicine Medical University of Innsbruck, Austria.
Innovations (Phila). 2020 May/Jun;15(3):279-282. doi: 10.1177/1556984520913292. Epub 2020 Apr 1.
Carcinoids of the left main bronchus are rare tumors of the bronchial system and patients often present with dyspnea, asthma-like symptoms, and pneumonia. Gold standard for therapy of carcinoids is surgical resection, but the surgical approach for segmental resection and anastomosis of the left main bronchus is a matter of discussion. With a left-sided approach the access to the bronchus is blocked by the aortic arch and the pulmonary vein. If a right-sided approach is performed, the problem of ventilation during resection and anastomosis of the bronchus occurs. We present a surgical approach from the right side using intraoperative extracorporeal membrane oxygenation to assure oxygen supply for resection of a typical carcinoid of the left main stem bronchus, and discuss the current literature.
左主支气管类癌是支气管系统罕见的肿瘤，患者常表现为呼吸困难、哮喘样症状和肺炎。类癌的金标准治疗方法是手术切除，但左主支气管节段切除和吻合的手术入路仍存在争议。左侧入路时，由于主动脉弓和肺静脉的存在，会阻塞气道的进入。如果采用右侧入路，则会在切除和吻合支气管时出现通气问题。我们介绍了一种从右侧入路的手术方法，术中使用体外膜肺氧合（ECMO）来保证切除左主支气管典型类癌时的氧气供应，并讨论了目前的文献。
