Marziali Valentina, Mangiameli Giuseppe, Crepaldi Alessandro, Piccioni Federico, Costantini Elena, Citterio Enrico, Borbone Alessandro, Cariboni Umberto
Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Front Surg. 2023 Aug 3;10:1238462. doi: 10.3389/fsurg.2023.1238462. eCollection 2023.
For a long time, non-small cell lung cancer (NSCLC) arising less than 2 cm distal to the carina has been usually considered unresectable and incurable with a radical or extended resection because of surgical technical difficulty and airway management. Recently, the introduction of more advanced surgical techniques, often including the use of extracorporeal life support (ECLS), has allowed us to extend the limits of conventional surgery, increasing the rate of complete surgical resection. ECLS also overcomes the limitation of conventional ventilation during complex tracheo-bronchial reconstruction, avoiding the presence of disturbing lines or tubes that obstruct the operative field during a challenging surgery. In this article, we share our experience in performing right tracheal sleeve pneumonectomy with veno-venous extracorporeal membrane oxygenation (VV-ECMO) in three cases by anterior right thoracotomy, reporting our tips and tricks.
长期以来，由于手术技术难度和气道管理问题，起源于隆突远端小于2 cm的非小细胞肺癌（NSCLC）通常被认为无法通过根治性或扩大切除术切除且无法治愈。最近，更先进的手术技术的引入，通常包括使用体外生命支持（ECLS），使我们能够扩展传统手术的界限，提高完全手术切除率。ECLS还克服了复杂气管支气管重建过程中传统通气的局限性，避免了在具有挑战性的手术中出现干扰手术视野的线路或管道。在本文中，我们分享了通过右前开胸术对3例患者进行右气管袖状肺叶切除术并使用静脉-静脉体外膜肺氧合（VV-ECMO）的经验，报告我们的技巧和窍门。
