Yoshimura H, Hirai S, Shinada J, Ishihara A
Rinsho Kyobu Geka. 1989 Dec;9(6):545-50.
Two cases of lung cancer performed combined resection of the aortic wall using extracorporeal circulation were discussed in this paper. One was 59-year old male and another was 63-year old male. Both had squamous cell carcinoma of the left upper lobe. CAT scan suggested the tumor invaded into the aortic wall, main pulmonary artery and left atrium in either patients. For the first case, separated perfusion to the upper half and lower half of his body, and for the second case, perfusion only to the lower half of the body were employed to resect and repair the aortic wall, using Dacron patch. For the first case, the left main pulmonary artery and the left atrial wall were resected in advance under the regular extracorporeal circulation. The first case died of the recurrence of the tumor 1 year and 7 months post-operatively, resulting the hemorrhage into the thoracic cavity. The second case died of empyema resulting massive hemorrhage from the anastomotic site of the patch 3 months post operatively. We think some managements such as the coverage of the synthetic graft with the omentum would be needed.
本文讨论了两例采用体外循环联合切除主动脉壁的肺癌病例。一例为59岁男性，另一例为63岁男性。两人均为左上叶鳞状细胞癌。计算机断层扫描显示，两名患者的肿瘤均侵犯主动脉壁、主肺动脉和左心房。第一例患者采用上半身和下半身分别灌注，第二例患者仅对下半身进行灌注，使用涤纶补片切除并修复主动脉壁。第一例患者在常规体外循环下预先切除左主肺动脉和左心房壁。第一例患者术后1年7个月死于肿瘤复发，导致胸腔出血。第二例患者术后3个月死于脓胸，补片吻合口大量出血。我们认为需要采取一些处理措施，如用大网膜覆盖人工血管。
