Murciano G, Aubier M, Desmonts J M, Servois V
Service de Chirurgie Thoracique et Cardio-vasculaire, Hôpital Bichat, Paris.
Ann Chir. 1993;47(2):152-6.
The authors report the case of a 64-year-old patient with a peripheral tumour of the left upper lobe developing in a context of bilateral major lesions of bullous emphysema with predominance on the right. Surgery first enabled the resection of large dystrophic compressive bullae of the right upper lobe, then, secondly, atypical resection of the culmen for excision of the peripheral tumour and dystrophic bullae of the left upper lobe. Twelve months later, a tumour recurrence led to left total pneumonectomy. Two radically different surgical approaches for carcinoma in a context of severe bullous emphysema are illustrated by this same patient. While the objective of functional improvement was associated with the oncological quality of excision at the time of the first stage of treatment, it was subsequently possible to perform major excision surgery with notable loss of functional capacity thanks to the benefits of the first operation.
作者报告了一例64岁患者的病例，该患者左上叶出现周围型肿瘤，同时存在双侧严重的大疱性肺气肿病变，右侧更为明显。手术首先切除了右上叶的巨大营养不良性压迫性肺大疱，其次，对肺尖进行了非典型切除，以切除左上叶的周围型肿瘤和营养不良性肺大疱。12个月后，肿瘤复发导致左全肺切除术。同一患者展示了在严重大疱性肺气肿背景下针对癌的两种截然不同的手术方法。虽然在治疗的第一阶段，功能改善的目标与切除的肿瘤学质量相关，但由于第一次手术的益处，随后有可能进行功能能力明显丧失的大切除手术。
