CAJ | 학술논문

目的总结双侧开胸治疗左主支气管病变侵及隆突的治疗体会.方法回顾分析中国医学科学院肿瘤医院1999年至2008年间4例双侧开胸治疗左主支气管病变侵及隆突的资料.结果 4例病人中男2例、女2例,中位年龄37.5岁(27～55岁).4例均采用双侧后外侧开胸切口,均行隆突切除成形术,其中3例行左侧全肺隆突切除,1例行气管隆突肿物切除.术后病理检查显示1例为结核,1例为鳞状细胞癌,另外2例为腺样囊性癌.3例术后呼吸机辅助通气,通气时间3～21d.手术死亡1例,死亡原因为吻合口裂开.结论对于相对年轻、心肺功能较好的左主支气管病变侵及隆突的患者,双侧后外侧开胸也是一种可以选择的方法.术中根据组织病理学类型和左主支气管侵犯的长度决定手术方式.
목적 총결쌍측개흉치료좌주지기관병변침급륭돌적치료체회.방법 회고분석중국의학과학원종류의원1999년지2008년간4례쌍측개흉치료좌주지기관병변침급륭돌적자료.결과 4례병인중남2례、녀2례,중위년령37.5세(27～55세).4례균채용쌍측후외측개흉절구,균행륭돌절제성형술,기중3례행좌측전폐륭돌절제,1례행기관륭돌종물절제.술후병리검사현시1례위결핵,1례위린상세포암,령외2례위선양낭성암.3례술후호흡궤보조통기,통기시간3～21d.수술사망1례,사망원인위문합구렬개.결론 대우상대년경、심폐공능교호적좌주지기관병변침급륭돌적환자,쌍측후외측개흉야시일충가이선택적방법.술중근거조직병이학류형화좌주지기관침범적장도결정수술방식.
Objective To investigate the outcome for surgical treatment of bilateral thoracotomy in patients with lesions of left main bronchus invading carina by bilateral thoracotomy. Methods The clinical data of 4 patients with lesions of left main bronchus invading carina undergoing bilateral thoracotomy were retrospectively reviewed. Results There were two male and two female patients with a median age of 37. S (range:27-55) years old. Four patients were all accessed by bilateral thoracotomy, and received carinal reconstruction. Of these 4 patients, three patients received left pneumonectomy and one patient received carinal resection without concomitant pulmonary resection. Pathological results showed that one patient had tuberculosis. And other three patients were of 1 squamous cell carcinoma and 2 adenoid cystic carcinomas. Three patients received mechanical ventilation for a period of 3-21 days, one patient died of anastomotic dehiscence at 5 days postoperatively. Conclusion Bilateral thoracotomy is an alternative approach for relatively young patients with decent cardiopulmonary functions with lesions of left main bronchus invading carina. Operation type should be based on histopathological type and length of involved left main bronchus.