自体肺叶再植治疗上叶中心型肺癌  

Treatment of Superior Lobe Central Lung Cancer with Lung Replantation

作　　者：杨玉伦[1] 赵文增 

机构地区：[1]郑州大学第一附属医院心脑外科,郑州4500052

出　　处：《中国肺癌杂志》2010年第11期1046-1049,共4页Chinese Journal of Lung Cancer

摘　　要：背景与目的肺癌患者行根治性全肺切除术后生活质量往往较差,最大限度地保留健康肺组织具有临床价值。本文报道3例自体肺再植在上叶中心型肺癌治疗中的应用和经验总结。方法本组共3例患者,肿瘤侵犯支气管或转移性淋巴结融合包绕、累及主肺动脉,肿瘤跨越斜裂侵及下叶边缘,先做完全性全肺切除术,体外低钾右旋糖酐液(low-potassium dextran,LPD)顺、逆行灌注后从离体标本中摘取可保留的下肺叶;下肺静脉再植于上肺静脉残端,按肺静脉、支气管、肺动脉顺序依次吻合。结果手术总时间220min-250min,下叶肺离体时间120min-150min;术后3d-5d拔除胸管,胸部X线示再植肺膨胀良好;术后随访4个月-8个月,完成3个或4个周期辅助化疗,患者生活质量良好。结论自体肺叶再植是一种可行的、可供选择的肺癌完全切除术式,是最大限度地切除病变和保留健康肺组织的理想术式。Background and objective Patients suffering from lung cancer often have poor quality of life after pneumonectomy.It has clinical significances to preserve maximum lobes of the ＂healthy＂ lung.The aim of this study is to report the applications of lung replantation in treatment of superior lobe central lung cancer.Methods Three lung cancer cases were included and analysed.The bronchus and margin of lower lung lobe were encroached by cancer.Pulmonary artery was invaded and surrounded by metastatic lymph node.Complete pneumonectomy,antegrade perfusion and retroperfusion with low-potassium dextran （LPD） solution in vitro were performed.The retainable lower pulmonary lobe was selected from the isolated lung and superior pulmonary vein was replaced with inferior pulmonary veins.The bronchus and pulmonary artery were inosculated by turns.Results The operative cumulative time ranged from 220 min to 250 min.The isolated time of lobus inferior pulmonary ranged from 120 min to 150 min.The chest tube was pulled out after chest X-ray confirmed the reimplant lung full re-expansion.The patients were followed up for 4 months to 8 months and accomplished adjuvant chemotherapy for 3 or 4 periodicities.The patients had a sound quality of life.Conclusion Lung replantation removing the extensive tumor tissue and retaining the maximum pulmonary normal tissue is an useful method for treatment of lung cancer.

关 键 词：肺肿瘤 肺切除术 自体肺再植 

分 类 号：R734.2[医药卫生—肿瘤]