肺癌的肺切除术后的支气管:如何使用旧的和创新的解决方案来管理这种危及生命的并发症
Antonio Mazzella1, Monica Casiraghi1, Clarissa Uslenghi1
1Division of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy.
Cancers
|March 28, 2024
概括
肺癌分管切除术后的支气管-多叶管 (BPF) 的有效管理涉及定制策略. 早期诊断和适当的干预,包括手术修复或完成肺切除术,对于改善患者的治疗结果至关重要.
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:
- 支气管-肺囊 (BPF) 是肺癌分管切除术后的一种严重并发症.
- 切后BPF的最佳管理策略需要仔细考虑多个因素.
研究的目的:
- 为了评估肺癌的分叶切除术后的支气管-多叶管 (BPF) 的有效管理.
- 分析诊断算法和治疗策略,以治疗手术后的BPF.
主要方法:
- 追溯对25年的经验 (1998-2023) 进行回顾,对手术后的BPF进行管理.
- 分析用于BPF解决的诊断算法和治疗策略.
主要成果:
- 在5150名为肺癌而进行叶叶切除术的患者中,44名 (0.85%) 在手术后出现了BPF.
- 治疗成功包括非侵入性方法 (11例),直接手术修复 (9例),补充干预 (14例),开窗胸口切除术 (6例) 和穿皮粘合剂注射 (2例).
- 发作的30天死亡率为18.2%,90天死亡率为22.7%.
结论:
- 血压压的管理是多因素的,取决于发病时间,大小,位置和患者的状况.
- 当初始疗法失败时,完成干预或开放窗口胸腔术是可行的选择.
- 及时和适当的管理对于减少与BPF相关的死亡率至关重要.
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