微创袖式肺叶切除手术:免疫治疗时代的机遇和挑战

Minimally invasive sleeve lobectomy: opportunities and challenges in the era of immunotherapy

袖式肺叶切除手术是局部晚期可切除中央型肺癌的一种标准治疗方式。与全肺切除手术相比,袖式肺叶切除手术可以在不影响患者生存的前提下,最大限度地通过保留肺组织而改善患者的生活质量。尽管支气管袖式肺叶切除增加了手术难度,但随着胸腔镜以及机器人技术的发展,微创袖式肺叶切除手术已经成为胸外科的常规术式。目前,随着免疫治疗在肺癌新辅助以及诱导治疗领域中的研究进展,越来越多的局部晚期可切除或潜在可切除的肺癌通过免疫治疗获得了根治的机会,这在改善患者预后的同时也为胸外科微创手术,尤其是微创袖式肺叶切除手术提出了更高的要求。本文对微创袖式肺叶切除手术的现状进行系统阐述以及前景展望。

Sleeve lobectomy, as a standard treatment for locally advanced resectable central lung cancer, can maximize the preservation of lung tissue and improve patients? quality of life without affecting survival, compared with total pneumonectomy. With the development of thoracoscopic and robotic technology, minimally invasive sleeve lobectomy has become a routine procedure in thoracic surgery, although bronchial sleeve lobectomy has increased the difficulty of operation. At present, with the development of immunotherapy in the field of neoadjuvant and induction therapy for lung cancer, a growing number of locally advanced resectable or potentially resectable lung cancer has been treated with immunotherapy. This not only improves the prognosis of patients, but also puts forward higher requirements for minimally invasive thoracic surgery, especially minimally invasive sleeve lobectomy. In this paper, the current situation of minimally invasive sleeve lobectomy is systematically described and the prospect is prospected.