论文部分内容阅读
目的 探讨应用自体肺重植技术治疗上叶中心型肺癌的可行性。方法 2例作双袖状右上中叶联合肺叶切除 ,因主支气管或肺动脉切除过长 ,吻合张力过大 ,遂切断下肺静脉 ,肺短时间离体后作下叶重植 ,将下肺静脉移植在上肺静脉残端。 2例左上叶肺癌部分侵及斜裂 ,无法进行双袖状肺叶切除术 ,作全肺切除后 ,在器械台上行肿瘤切除 ,将修剪后的下叶肺组织重植。结果 随访至 2 0 0 0年 2月 ,2例病人已分别无瘤存活 33和 2 0个月 ,生活质量良好。 1例术后 19d死于支气管胸膜瘘、张力性气胸 ;另 1例术后 42d因肺动脉、支气管胸膜瘘 ,作重植肺切除 ,术后 14个月死于肺部感染所引起的呼吸衰竭。结论 对心肺功能不能耐受全肺切除的III期上叶中心型肺癌病人 ,自体肺重植是一种可供选择的、能保全肺组织的肺癌根治术式。
Objective To explore the feasibility of using autologous lung replantation in the treatment of upper center lung cancer. Methods 2 cases of double-sleeve combined with the right upper lobe and lobectomy because of the main bronchus or pulmonary artery resection is too long, anastomotic tension is too large, then cut off the lower pulmonary vein, the lungs for a short time after implantation for lower lobe replantation, the lower pulmonary vein transplantation in the upper pulmonary veins end. Two cases of left upper lobe lung cancer invading oblique splitting, can not be double-sleeve lobectomy, for pneumonectomy, tumor resection on the instrument stage, the trimmed lower lobe lung tissue replantation. Results The follow-up to February 2000, 2 patients had tumor-free survival of 33 and 20 months, good quality of life. One patient died of bronchopleural fistula and tension pneumothorax at 19 days after operation. The other patient underwent pulmonary resection at 42 days after operation due to pulmonary artery and bronchopleural fistula, and died of respiratory failure at 14 months after operation. Conclusions Autologous lung replantation is an alternative radical surgery for lung cancer that preserves lung tissue in stage III upper lobe patients with cardiopulmonary function who can not tolerate pneumonectomy.