CAJ | 학술논문

目的探讨肺移植治疗肺部恶性肿瘤的手术适应证、围手术期的处理及疗效.方法 2002年9月至2012年12月单中心4例肺部恶性肿瘤患者接受了肺移植.1例为肺泡细胞癌,2例为支气管源性肺癌伴终末期肺疾病,1例为转移性肺癌.移植前4例肺功能均差,存在不同程度的呼吸衰竭.4例中,2例行序贯式双肺移植,2例行单肺移植,其中1例单肺移植在体外膜肺氧合辅助下完成.结果 1例于术后25个月死于肿瘤复发,其他3例至随访截止已分别存活11个月、1年和8个月,肺功能良好,未出现肿瘤复发、转移的表现.结论支气管源性肺癌伴终末期肺疾病(包括弥漫性细支气管肺泡细胞癌)及转移性肺癌,不能耐受其他治疗或对其他治疗无效,短期内会因肺功能进行性下降、呼吸衰竭而导致死亡是肺移植的相对适应证,可考虑行肺移植评估,但受者的长期存活还需进一步随访.
목적 탐토폐이식치료폐부악성종류적수술괄응증、위수술기적처리급료효.방법 2002년9월지2012년12월단중심4례폐부악성종류환자접수료폐이식.1례위폐포세포암,2례위지기관원성폐암반종말기폐질병,1례위전이성폐암.이식전4례폐공능균차,존재불동정도적호흡쇠갈.4례중,2례행서관식쌍폐이식,2례행단폐이식,기중1례단폐이식재체외막폐양합보조하완성.결과 1례우술후25개월사우종류복발,기타3례지수방절지이분별존활11개월、1년화8개월,폐공능량호,미출현종류복발、전이적표현.결론 지기관원성폐암반종말기폐질병(포괄미만성세지기관폐포세포암)급전이성폐암,불능내수기타치료혹대기타치료무효,단기내회인폐공능진행성하강、호흡쇠갈이도치사망시폐이식적상대괄응증,가고필행폐이식평고,단수자적장기존활환수진일보수방.
Objective To discuss the operative indication,perioperative management and therapeutic effect of lung transplantation for lung cancer.Methods Lung transplantations (LTx) were performed in four cases of lung cancer in our center since 2002,including one case of bronchioloalveolar carcinoma (BAC),2 cases of bronchogenic carcinoma concomitant with end-stage lung disease,and one case of neoplasm metastasis.Four patients all suffered from poor pulmonary function and respiratory failure to varying degrees prior to LTx.Two patients received bilateral sequence lung transplantation,and 2 patients single lung transplantation.One patient was subjected to extracorporeal membrane oxygenation (ECMO) support.Results Case 1 died of tumor recurrence on postoperative month 25.During the follow-up period,the remaining three patients were alive for 11 months,1 year and 8 months respectively,and lived with satisfied pulmonary function.No tumor recurrence and metastasis were seen in these three patients.Conclusion LTx can be performed to treat bronchogenic carcinoma concomitant with end-stage lung disease and neoplasm metastasis,yet the patients should be carefully selected.Long-term survival requires further investigations.