在高风险单肺患者中治疗支气管-食道的多学科治疗
Rune Haaverstad1,2, Kjell Ovrebo3, Lorentz Sandvik4
1Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway. rune.haaverstad@helse-bergen.no.
Journal of cardiothoracic surgery
|January 11, 2025
概括
支气管-食道 (BEF) 的手术修复即使在复杂的情况下也是可能的. 这一案例表明,在患者之前接受过肺癌治疗后,BEF进行了广泛的手术后,成功的长期康复.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 关键护理医学 关键护理医学
背景情况:
- 支气管-食道 (BEF) 是一种严重的并发症,通常通过支架进行缓解治疗.
- 对BEF的支架治疗带有迁移,侵蚀和组织亡的风险.
- 对BEF的最终治疗方法是手术修复.
研究的目的:
- 报告一个复杂的支气管-食道的成功手术管理.
- 突出在高风险患者中进行激进手术的可行性.
- 在复杂的外科病例中强调多学科合作和道德考虑的重要性.
主要方法:
- 一名40岁的女性患者有肺切除术和放射化疗病史,为晚期肺癌呈现了BEF.
- 这位患者有显著的并发症,包括自身免疫性疾病,单一的肺和声带.
- 治疗包括临时支架,静脉静脉ECMO,分阶段双侧胸切除术和腹腔切除术,广泛的胸切除术,高风险解剖,食道切除术和带有乳肌的支气管整形术.
主要成果:
- 患者接受了复杂的,分阶段的手术程序来修复BEF.
- 手术后的并发症包括静脉血栓,出血和严重疾病神经病变.
- 患者康复并在150天后出院,在手术后的5年里,生活质量良好,独立生活.
结论:
- 即使在极其复杂的患者中,BEF的手术治疗也可以成功.
- 成功的结果需要仔细的伦理评估,全面的手术策略和多学科的团队合作.
- 与患者共享决策对于管理这些具有挑战性的病例至关重要.
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