Mangiameli Giuseppe, Testori Alberto, Cioffi Ugo, Alloisio Marco, Cariboni Umberto
Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Front Oncol. 2022 Nov 25;12:1005929. doi: 10.3389/fonc.2022.1005929. eCollection 2022.
The use of extracorporeal lung support (ECLS) during thoracic surgery is a recent concept that has been gaining increasing approval. Firstly introduced for lung transplantation, this technique is now increasingly adopted also in oncological thoracic surgical procedures. In this review, we focus on the cutting-edge application of extracorporeal membrane oxygenation (ECMO) during oncological thoracic surgery. Therefore, we report the most common surgical procedures in oncological thoracic surgery that can benefit from the use of ECMO. They will be classified and discussed according to the aim of ECMO application. In particular, the use of ECMO is usually limited to certain lung surgery procedures that can be resumed such as in procedures in which an adequate ventilation is not possible such as in single lung patients, procedures where conventional ventilation can cause conflict with the surgical field such as tracheal or carinal surgery, and conventional procedures requiring both ventilators and hemodynamic support. So far, all available evidence comes from centers with large experience in ECMO and major thoracic surgery procedures.
在胸外科手术中使用体外肺支持(ECLS)是一个最近才出现且越来越被认可的概念。该技术最初用于肺移植,如今在肿瘤胸外科手术中也越来越多地被采用。在本综述中,我们聚焦于体外膜肺氧合(ECMO)在肿瘤胸外科手术中的前沿应用。因此,我们报告了肿瘤胸外科手术中最常见的可受益于ECMO使用的手术操作。它们将根据ECMO应用的目的进行分类和讨论。特别是,ECMO的使用通常限于某些可恢复的肺部手术操作,例如在单肺患者中无法实现充分通气的手术、传统通气会与手术视野产生冲突的手术(如气管或隆突手术)以及需要呼吸机和血流动力学支持的传统手术。到目前为止,所有现有证据均来自在ECMO和大型胸外科手术方面经验丰富的中心。