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气管切除与吻合手术的创新方法:整合体外膜肺氧合以提高安全性。

Innovative Approaches in Tracheal Resection and Anastomosis Surgery: Integrating Extracorporeal Membrane Oxygenation for Enhanced Safety.

作者信息

Son Joohyung, Son Bong Soo, Park Jong Myung, Cho Jeong Su, Kim Yeongdae, I Hoseok, Kim Do Hyung

机构信息

Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Transplantation Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

出版信息

Yonsei Med J. 2025 May;66(5):289-294. doi: 10.3349/ymj.2024.0236.

Abstract

PURPOSE

Tracheal resection with end-to-end anastomosis (TREE) has many advantages over conservative treatment in terms of long-term results; however, this method requires improved safety and accessibility. We aimed to combine expanded venovenous extracorporeal membrane oxygenation (ECMO) during TREE surgery.

MATERIALS AND METHODS

Between May 2006 and December 2022, 41 patients diagnosed with tracheal stenosis or tracheal tumors underwent TREE. The non-ECMO and ECMO groups were classified based on the presence or absence of intraoperative ECMO support.

RESULTS

Reconstruction length was slightly longer in the ECMO group than in the non-ECMO group, but there was no statistical significance (=0.082). There was no significant difference between the two groups in terms of operative time (=0.698), estimated blood loss (=0.210), and duration of mechanical ventilation (=0.713). There was a significant difference in intensive care unit stay between the two groups (=0.013) due to the postoperative maintenance of ECMO. There were no cases of early mortality in either group during hospitalization (>0.999).

CONCLUSION

ECMO support could assist in more challenging cases as it makes surgery easier in difficult patient scenarios.

摘要

目的

就长期效果而言,气管端端吻合切除术(TREE)相较于保守治疗有诸多优势;然而,该方法需要提高安全性和可及性。我们旨在将体外膜肺氧合(ECMO)应用于TREE手术中。

材料与方法

2006年5月至2022年12月期间,41例被诊断为气管狭窄或气管肿瘤的患者接受了TREE手术。非ECMO组和ECMO组根据术中是否有ECMO支持进行分类。

结果

ECMO组的重建长度略长于非ECMO组,但无统计学意义(=0.082)。两组在手术时间(=0.698)、估计失血量(=0.210)和机械通气时间(=0.713)方面无显著差异。由于术后需维持ECMO,两组在重症监护病房的住院时间存在显著差异(=0.013)。两组住院期间均无早期死亡病例(>0.999)。

结论

ECMO支持可辅助处理更具挑战性的病例,因为它能使困难患者情况下的手术更顺利。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30e6/12041403/f9a0606ef1d5/ymj-66-289-g001.jpg

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