Karasaki Takahiro, Fujimori Sakashi, Suzuki Souichiro, Kikunaga Shinichiro, Ito Kazuki, Hamada Yosuke, Mihara Shusei
Department of Thoracic Surgery, Respiratory Center, Toranomon Hospital, Tokyo, Japan.
Interdiscip Cardiovasc Thorac Surg. 2025 Feb 5;40(2). doi: 10.1093/icvts/ivaf012.
This study aimed to assess the feasibility and retention rates of pedicled thymic flaps to enhance understanding of bronchial stump coverage. A retrospective analysis of 22 consecutive patients who underwent anatomical lung resection followed by bronchial stump coverage with pedicled thymic flaps between January 2017 and December 2022 was conducted. The procedure was performed using a minimally invasive three-port video-assisted thoracoscopic surgery technique for all patients with no complications related to graft harvest or fixation. Postoperative retention of the engrafted flaps was evaluated in the 16 patients who underwent thin-slice computed tomography at least once after surgery. The majority of the postoperative computed tomography examinations were performed for surveillance of lung cancer recurrence. The retention rates of pedicled thymic flaps were 100% at 60 days, 87% at 180 days and 70% at 1 year post-surgery. Pedicled thymic flaps can be safely harvested using a minimally invasive approach, and the majority of engrafted flaps remain adjacent to the bronchial stump for more than 1 year. This technique may be a viable option for patients at high risk of a delayed bronchopulmonary fistula.
本研究旨在评估带蒂胸腺瓣的可行性和保留率，以增进对支气管残端覆盖的理解。对2017年1月至2022年12月期间连续22例行解剖性肺切除并采用带蒂胸腺瓣覆盖支气管残端的患者进行了回顾性分析。所有患者均采用微创三端口电视辅助胸腔镜手术技术进行手术，未发生与移植物获取或固定相关的并发症。对术后至少进行过一次薄层计算机断层扫描的16例患者评估植入瓣的术后保留情况。术后大多数计算机断层扫描检查是为了监测肺癌复发。带蒂胸腺瓣的保留率在术后60天为100%，180天为87%，1年为70%。带蒂胸腺瓣可通过微创方法安全获取，且大多数植入瓣在支气管残端旁保留超过1年。对于有延迟性支气管肺瘘高风险的患者，该技术可能是一种可行的选择。
