隆凸切除与重建在气道肿瘤外科治疗中的应用

doi:10.3877/cma.j.issn.2095-8773.2017.04.12

隆凸的切除与重建是一种较为复杂的外科手术，该术式应用较少，术后并发症发生率高于标准的肺叶切除术式，对胸外科医师具有极大的挑战性。此类肿瘤多见于侵犯主支气管的中央型肺癌及隆凸来源肿瘤。在切除隆凸的同时，常需要进行全肺或部分肺叶切除术，并通过复杂的气道重建工作以保持其连续性。因此，为达到最佳的手术效果需要严格的筛选患者、合理的手术计划、适当的术后监护以及胸外科术者和麻醉团队的通力协作。该文旨在对隆凸切除与重建术治疗隆凸肿瘤及支气管肺癌的外科操作技术和围手术期管理经验进行总结。

关键词: 隆凸切除与重建, 袖式切除, 隆凸肿瘤, 肺癌

Resection and reconstruction of the carina is a complex and rare surgical procedure with higher postoperative complications than standard resection, which is a great challenge for thoracic surgeons. Such tumors are more common in the central lung cancer involving the main bronchus and primary carcinoma of the carina. These patients often require pneumonectomy during carinal resection with complicated reconstructive efforts to establish airway continuity. Thus, strict patient selection, appropriate operation plan, proper perioperative care and execution by both thoracic surgery and anesthesia teams are required for optimal results. The aim of this thesis is to summarize the surgical technique and perioperative management of carinal resection and reconstruction in the treatment of airway malignancies.

Key words: Carinal resection and reconstruction, Sleeve resection, Carina tumor, Lung cancer

图1 隆凸切除与重建术式

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The application of carinal resection and reconstruction in surgical treatment for airway malignancies

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The application of carinal resection and reconstruction in surgical treatment for airway malignancies