Astudillo Pombo J, Bravo Masgoret C, Margarit Creixell C, Guillermo Rodríguez M L, Tenorio López L
Servicio de Cirugía Torácica, Hospital General Universitario Vall d'Hebron, Barcelona.
Arch Bronconeumol. 1994 Aug-Sep;30(7):348-53. doi: 10.1016/s0300-2896(15)31045-0.
Patients who suffer advanced lung disease associated to respiratory infection and who are candidates for transplantation must have both lungs replaced. Until recently, this procedure was accomplished by transplanting a heart-lung block, a procedure of questionable merit if the heart is healthy, or by carrying out a double-lung transplant requiring extracorporeal circulation and involving a high percentage of complications the tracheal anastomosis. The year 1990 saw publication of the first descriptions of a simpler procedure, sequential double-lung transplantation. After brief experience with good results in single-lung transplantation, we present the first three cases of sequential double-lung replacement carried out in Spain. We describe the consecutive substitution of both lungs, with no need for extracorporeal circulation in most cases. Sequential bilateral lung transplantation combines the advantages of single-lung transplantation with the use of anterior thoracoesternotomy to provide good access to both pleural cavities, facilitating the procedure when pleural adhesion is present.
患有与呼吸道感染相关的晚期肺部疾病且适合进行移植的患者必须替换双肺。直到最近，该手术是通过移植心肺联合块来完成的，如果心脏健康，这种手术的优点存疑，或者通过进行需要体外循环且气管吻合术并发症发生率很高的双肺移植来完成。1990年首次发表了关于一种更简单手术——序贯双肺移植的描述。在单肺移植取得良好效果的短暂经验之后，我们介绍在西班牙进行的前三例序贯双肺置换病例。我们描述了双肺的连续置换，大多数情况下无需体外循环。序贯双侧肺移植结合了单肺移植的优点，并采用前胸部正中切口以便很好地进入双侧胸腔，在存在胸膜粘连时便于手术操作。
