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支气管内平滑肌瘤的支气管镜下切除术:长期成功结果的证据

Bronchoscopic Excision of Endobronchial Leiomyoma: Evidence for Successful Long-Term Outcome.

作者信息

Yap Elaine

机构信息

Department of Respiratory Medicine Middlemore Hospital, Te Whatu Ora Counties Manukau Auckland New Zealand.

出版信息

Respirol Case Rep. 2025 Sep 18;13(9):e70344. doi: 10.1002/rcr2.70344. eCollection 2025 Sep.

Abstract

Pulmonary leiomyomas are rare benign tumours of bronchial smooth muscle origin. They can present either in the lung parenchyma or tracheobronchial tree, with 45% being located endobronchially. Endobronchial leiomyomas typically present with airways symptoms such as dyspnoea, cough, and obstructive pneumonia. Traditionally, endobronchial leiomyomas were managed surgically with lobectomy or pneumonectomy but, increasingly, management has shifted to bronchoscopic resection with different endoscopic techniques described in the case report literature. Most reports include outcomes ranging from 3 to 6 months following bronchoscopic resection. We present a case of a 40-year-old female with a left upper lobe (LUL) leiomyoma who presented with complete LUL collapse consolidation. Bronchoscopic resection was performed using a combination of diathermy snare, cryo-recanalisation, and argon plasma coagulation (APC) which resulted in excellent restoration of the LUL patency. Annual bronchoscopy surveillance over 7 years confirmed durability of the procedure with no recurrence detected.

摘要

肺平滑肌瘤是起源于支气管平滑肌的罕见良性肿瘤。它们可出现在肺实质或气管支气管树中,45%位于支气管内。支气管内平滑肌瘤通常表现为气道症状,如呼吸困难、咳嗽和阻塞性肺炎。传统上,支气管内平滑肌瘤通过肺叶切除术或全肺切除术进行手术治疗,但越来越多地,治疗已转向支气管镜下切除,病例报告文献中描述了不同的内镜技术。大多数报告包括支气管镜切除术后3至6个月的结果。我们报告一例40岁女性,患有左上叶平滑肌瘤,表现为左上叶完全塌陷实变。使用透热圈套器、冷冻再通和氩等离子体凝固(APC)联合进行支气管镜切除,使左上叶通畅得到了很好的恢复。7年的年度支气管镜监测证实了该手术的持久性,未发现复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85f8/12444774/b03d2c942716/RCR2-13-e70344-g003.jpg

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