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左上部划分分段切除术与肺部扩张和支气管形性肺部切除术相比
Wongi Woo1, Chul Hwan Park2, Jimin Lee1
1Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Annals of surgical oncology
|April 1, 2024
概括
左上分段切除术在左上叶损伤的叶片切除术上提供了功能上的好处,可能减少持续咳并保持肺部体积. 这种肺癌手术可能会改善患者的治疗结果.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 手术瘤学手术瘤学
背景情况:
- 左上分段切除术与左上叶片切除术对左上叶片病变的功能益处正在争论中.
- 评估临床和功能结果对于手术决策至关重要.
研究的目的:
- 为了比较左上叶片切除术和左上部分切除术之间的临床和功能结果.
- 评估每个手术对肺体积,支气管几何学和术后呼吸道症状的影响.
主要方法:
- 对135名左上叶病变患者的回顾性分析 (110个叶片切除术,25个细分切除术).
- 倾向性得分匹配对比组的比较.
- 螺旋测量,CT体积评估 (支气管角度/扭曲),并检查症状的医疗记录.
主要成果:
- 分段切除组的瘤较小,但在匹配后具有相似的术前特征.
- 手术后的螺旋测量结果类似;然而,细分切除术显示肺体积减少较小 (p=0.004).
- 肺切除组表现出左侧主要支气管曲度增加 (p=0.013) 和持续咳的更高率 (p=0.001).
结论:
- 左上部划分分段切除术可以防止明显的支气管角化.
- 细分切除术似乎有望减少肺癌患者的术后持续咳.
- 这种方法可以作为选择左上叶损伤的叶片切除术的可行替代方案.
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