Atyukov M A, Zhemchugova-Zelenova O A, Petrov A S, Zemtsova I Yu
State Multi-Field Hospital No.2, St. Petersburg, Russia.
St. Petersburg State University, St. Petersburg, Russia.
Khirurgiia (Mosk). 2024(7):130-140. doi: 10.17116/hirurgia2024071130.
We demonstrated successful treatment of patients with complicated central lung cancer, who underwent right upper sleeve lobectomy with carinal resection. We have used the following options for carinal reconstruction: anastomosis of trachea with the left main bronchus and anastomosis of intermediate bronchus with the left main bronchus (clinical case No. 1) or with trachea (clinical case No. 2). Cervicothoracotomy provided correct N-staging and mobilization of trachea with left main bronchus. This approach provided compliance with oncological principles of surgical treatment of lung cancer and significantly reduced tension of anastomosis. These aspects are important for satisfactory immediate functional and oncological results after right upper sleeve lobectomy with carinal resection.
我们展示了对患有复杂中央型肺癌的患者进行成功治疗的案例,这些患者接受了右上叶袖状肺叶切除术并伴有隆突切除。我们对隆突重建采用了以下方法:气管与左主支气管吻合以及中间支气管与左主支气管吻合(临床病例1)或与气管吻合(临床病例2)。颈胸联合切口能够准确进行N分期,并可游离气管与左主支气管。这种方法符合肺癌外科治疗的肿瘤学原则,并显著降低了吻合口的张力。这些方面对于右上叶袖状肺叶切除术并伴有隆突切除术后获得满意的近期功能和肿瘤学效果非常重要。