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尊重中叶:比洛贝克切除术的外科手术风险与洛贝克切除术和肺切除术相比
Andrew X Li1, Maureen E Canavan1, Theresa Ermer1
1Section of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
The Annals of thoracic surgery
|September 29, 2023
概括
肺癌的比洛贝克切除术的发病率和死亡率明显高于带切除术,与肺切除术相比. 在考虑中叶切除时,仔细进行手术前风险评估至关重要.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 肺部医学 肺部医学
背景情况:
- 在右侧肺癌中,由于瘤扩张,支气管透或肺动脉透,可能需要进行双管切除术.
- 中叶对肺功能的贡献被认为是很小的,但双叶切除术的风险没有得到充分证实.
研究的目的:
- 为了比较30天的外科手术期间的死亡率和发病率,比洛贝克切除术与肺癌的肺切除术和肺切除术.
- 为了评估上方与下方双眼切除术的结果.
主要方法:
- 对胸部外科医生协会数据库 (2009-2017) 的回顾性分析.
- 包括为肺癌而接受带切除术,双切除术或肺切除术的患者.
- 使用倾向匹配和考克斯比例危险模型来比较结果.
主要成果:
- 双眼切除术的30天死亡率与左侧肺切除术相比较,但结果明显比左侧或右侧肺切除术更差.
- 与右侧肺切除术相比,双眼切除术显示了生存优势.
- 比洛贝克切除术的30天发病率高于皮切除术,上部比洛贝克切除术显示出比下部比洛贝克切除术的死亡率优势.
结论:
- 比洛贝克切除术与带切除术相比,患病率和死亡率明显高,死亡率与左侧肺切除术相似.
- 在肺切除术中包括中叶切除术的决定需要仔细的手术前风险分层,因为相关风险.
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