Giller Dmitry B, Rückert Jens C, Giller Boris B, Kesaev Oleg Sh, Imagozhev Yakub G, Scherbakova Galina V
M.I.Perelman Department of Phthisiopulmonology and Thoracic Surgery, Sechenov University, Moscow, Russia.
Department of Surgery, Competence Center of Thoracic Surgery, Charite' University Hospital Berlin, Berlin, Germany.
Int J Surg Case Rep. 2020;77:773-777. doi: 10.1016/j.ijscr.2020.11.103. Epub 2020 Nov 21.
Single lung resection remains a challenge due to the preservation of the respiratory reserve. This report presents that case of a female patient with bilateral fibrotic-cavitary pulmonary tuberculosis complicated with empyema on the right lung. Only 3.5 lung segments were left after a multistage surgery.
The first stage included draining of empyema and transsternal transmediastinal right main bronchus occlusion. Then, upper lobectomy with partial S6 resection of the left lung, followed by pleuropneumonectomy was performed. At a follow-up of two years and 10 months, patient's condition was good.
Although single lung surgery has been possible over half a century ago, it remains a high-risk intervention.
With the removal of the non-functioning parenchyma and elimination of the air/vascular shunt, single lung resection volume exceeding lobectomy is possible, which may improve cardiorespiratory function.
由于要保留呼吸储备功能，单肺切除术仍然是一项挑战。本报告介绍了一名患有双侧纤维空洞型肺结核并伴有右肺脓胸的女性患者的病例。经过多阶段手术后仅剩下3.5个肺段。
第一阶段包括引流脓胸和经胸骨经纵隔右主支气管闭塞术。然后，进行了左肺上叶切除术并部分切除S6，随后进行了胸膜肺切除术。在两年零十个月的随访中，患者情况良好。
尽管半个多世纪前就已经能够进行单肺手术，但它仍然是一种高风险的干预措施。
通过切除无功能的实质组织并消除气/血管分流，有可能进行超过肺叶切除术的单肺切除量，这可能改善心肺功能。
