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体外膜肺氧合辅助下双侧单孔胸腔镜隆突切除重建术:一例报告

ECMO-assisted bilateral uniportal thoracoscopic carinal resection and reconstruction: a case report.

作者信息

Wu Bin, Sheng Yinliang, Geng Zhenyang, Xu Yiming, Fan Xueyuan, Yuan Ping, Li Feng, Qi Yu

机构信息

Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

J Cardiothorac Surg. 2025 Jan 3;20(1):1. doi: 10.1186/s13019-024-03196-7.

Abstract

BACKGROUND

Carinal resection and reconstruction are complex surgical procedures often necessitated by tumors or other pathologies involving the tracheobronchial junction. Traditional approaches to these surgeries are highly invasive. The advent of uniportal video-assisted thoracoscopic surgery (VATS) along with the integration of extracorporeal membrane oxygenation (ECMO) offer potential advantages in reducing surgical trauma and improving outcomes.

CASE PRESENTATION

A 42-year-old female patient was admitted to the hospital with the chief complaint of "chest tightness for 20 days". Enhanced chest CT revealed a soft tissue shadow on the tracheal bifurcation wall, protruding into the left main bronchus opening. After multidisciplinary discussions and the exclusion of surgical contraindications, we performed ECMO-assisted uniportal VATS carinal resection and reconstruction for the patient. The patient's postoperative course was uneventful, and she was discharged on postoperative day 4 with satisfactory respiratory function and no major complications.

CONCLUSIONS

This case demonstrates the feasibility and potential benefits of combining ECMO support with uniportal VATS for complex carinal surgeries. The approach minimizes surgical trauma, ensures stable intraoperative conditions, and may enhance postoperative recovery. Further studies are warranted to validate these findings and establish standardized protocols for such advanced surgical techniques.

摘要

背景

隆突切除与重建是复杂的外科手术,通常因涉及气管支气管交界处的肿瘤或其他病变而需要进行。这些手术的传统方法具有高度侵入性。单孔电视辅助胸腔镜手术(VATS)的出现以及体外膜肺氧合(ECMO)的整合在减少手术创伤和改善预后方面具有潜在优势。

病例介绍

一名42岁女性患者因“胸闷20天”入院。胸部增强CT显示气管隆突壁有软组织阴影,突入左主支气管开口。经过多学科讨论并排除手术禁忌证后,我们为该患者进行了ECMO辅助下单孔VATS隆突切除与重建术。患者术后恢复顺利,术后第4天出院,呼吸功能良好,无重大并发症。

结论

本病例证明了将ECMO支持与单孔VATS相结合用于复杂隆突手术的可行性和潜在益处。该方法可将手术创伤降至最低,确保术中情况稳定,并可能促进术后恢复。有必要进行进一步研究以验证这些发现,并为此类先进手术技术建立标准化方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0c7/11697856/acdbc5268425/13019_2024_3196_Fig1_HTML.jpg

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