应用自体肺移植技术治疗上叶中心型肺癌(英文)  

Lung autotransplantation technique for treating central lung cancer of upper lobe

作　　者：张国良[1] 刘军[1] 姜冠潮[1] 沈晨阳[1] 李梦赞[1] 

机构地区：[1]北京医科大学人民医院胸外科,中国100044

出　　处：《中华外科杂志》2000年第4期245-249,共5页Chinese Journal of Surgery

摘　　要：目的　探讨应用自体肺移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 ,因支气管切除过长或肺动脉切除过长 ,吻合张力过大 ,做下肺静脉切断 ,肺短时间离体后作下叶重植 ,将下肺静脉移植于上肺静脉残端。 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 ,行全肺切除后 ,在器械台上行肿瘤切除 ,下叶修剪后重植于胸腔内。　结果　随访至 1999年 12月 ,第 1、3、4例患者已分别无瘤存活 31、18和 13个月。第 1和 3例患者生活质量良好 ,但第 4例患者活动能力极差。第4例术后 42d因肺动脉、支气管胸膜瘘 ,做移植肺切除。第 2例术后 19d死于支气管胸膜瘘、张力性气胸。　结论　对心肺功能不能耐受全肺切除的III期上叶中心型肺癌患者 。Objective To assess the feasibility of applying lung autotransplantation technique in the treatment of central lung cancer of the upper lobe. Methods Two patients underwent double sleeve right upper and middle bilobectomy. Because the length of resected bronchus or pulmonary artery involved by tumor was too long to perform tension free anastomosis, we had to transplant the lower lobar vein into the proximal stump of the upper lobar vein. Another two patients underwent pneumonectomy firstly, because we could not perform sleeve lobectomy in suit as the tumor extended through the oblique fissure to the margin of the lower lobe. Subsequently, we resected the tumor parts at a separate table, and replanted the preservable part of the lung into the chest. Results Being followed up to December 1999, the patient 1,3 and 4 had been alive with tumor free for 31,18 and 13 months. The patient 1 and 3 had a good living quality but the patient 4 had a very poor activity. The patient 4 received resection of the replanted lung for pulmonary artery bronchus pleural fistula on the 42nd day after operation. The second patient died of tension pneumothorax associated with bronchopleural fistula on the 19th day after operation. Conclusion Lung autotransplantation is an alternative technique for pulmonary preservation in patients with stage Ⅲ central lung cancer of the upper lobe whose cardiopulmonary function is too poor to undergo pneumonectomy.

关 键 词：上叶中心型肺癌 自体肺移植 疗效 

分 类 号：R734.2[医药卫生—肿瘤]