非小细胞肺癌癌症患者的肺切除和脊袖切除。

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Thoracic and Cardiovascular Surgeon Pub Date : 2024-04-01 Epub Date: 2023-10-26 DOI:10.1055/a-2199-2164
Dominik Herrmann, Urim Starova, Melanie Oggiano, Luiza Alexandra Luta, Shadi Hamouri, Santiago Ewig, Erich Hecker, Robert Scheubel
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引用次数: 0

摘要

背景脊袖切除肺切除术是胸部手术中最罕见的手术之一,但对于局部晚期中央型癌症伴隆突浸润的患者,完全切除是一种选择。此外,它可能是全肺切除术后残端功能不全患者或袖叶切除术后吻合口裂开患者的选择方法。本次调查的目的是评估接受套筒式全肺切除术的癌症非小细胞肺癌患者的发病率和长期生存率。方法将2003年9月至2021年12月在我科连续行隆胸袖状全肺切除术的癌症(NSCLC)患者纳入本研究。对人口统计学特征、围手术期变量(包括并发症和长期生存率)进行了分析。对数据进行回顾性评价。结果31例非小细胞肺癌(pSP)患者行肺切除加隆突袖切除术,19例因支气管残端功能不全作为肺切除加隆突袖切除或支气管吻合口裂开肺切除术(sSP)的并发症而得到治疗。并发症发生在30名患者中(60%),90天死亡率为18%(n=9)。pSP患者的总生存期估计为39.6个月,而sSP后患者的总存活期估计为24.5个月(p=0.01)。N-状态似乎不会影响结果。结论脊袖切除加全肺切除术是一种可行的手术方法,其发病率和死亡率都很低。在强制性患者选择后,该程序是局部晚期中枢性非小细胞肺癌患者的合理治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pneumonectomy with Carinal Sleeve Resection in Patients with Non-Small-Cell Lung Cancer.

Background:  Carinal sleeve resection with pneumonectomy is one of the rarest procedures in thoracic surgery, but for locally advanced central lung cancer with infiltration of the carina, it is an option to achieve complete resection. Additionally, it might be the method of choice for patients with stump insufficiency after pneumonectomy or in the cases with anastomosis dehiscence after sleeve lobectomy. The aim of this study was to evaluate the morbidity and long-term survival of patients with non-small-cell lung cancer (NSCLC) who underwent sleeve pneumonectomy, either for curative intent or as an option to treat postoperative complications.

Methods:  All consecutive patients with NSCLC who underwent carinal sleeve pneumonectomy for the aforementioned indications in our department between December 2021 and September 2003 were included in this study. An analysis of demographic characteristics, perioperative variables, and long-term survival was carried out. Data were evaluated retrospectively.

Results:  Fifty patients underwent pneumonectomy with carina sleeve resection. Thirty-one cases for curative treatment of NSCLC (primary sleeve pneumonectomy [pSP]) and 19 patients were treated because of postpneumonectomy bronchial stump insufficiency or bronchial anastomosis dehiscence (secondary sleeve pneumonectomy [sSP]). Complications occurred in 30 patients (60%) and the 90-day mortality was 18% (n = 9). Patients with pSP had an estimated overall survival of 39.6 months, compared to estimated overall survival for patients after sSP of 24.5 months (p = 0.01). The N status did not appear to affect outcomes.

Conclusion:  Carinal sleeve resection with pneumonectomy is a feasible procedure with limited morbidity and mortality. This procedure is a reasonable therapeutic option for patients with locally advanced central NSCLC after mandatory patient selection.

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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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