Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected a...Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the ＂lobular bronchi＂ with main bronchi Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.展开更多
Objective: Bronchoplastic and pulmonary arterioplastic procedures have become increasingly popular in recent years as an alternative to pneumonectomy, especially for the patients with compromised cardiopulmonary reser...Objective: Bronchoplastic and pulmonary arterioplastic procedures have become increasingly popular in recent years as an alternative to pneumonectomy, especially for the patients with compromised cardiopulmonary reserve. Our experience with the procedures was reviewed and the operative technique, indication for the procedures, and long-term results were analyzed. Methods: From January 1977 to December 1996, 65 bronchoplasties, 4 pulmonary arterioplasties, and 3 combined broncho-angioplasties were performed for bronchogenic carcinoma. Of the 72 patients, thirty-one had stage I disease, 29 stage II and 12 stage III. Results: One patient (1.4%) died of bilateral pneumonitis after operation. Atelectasis occurred in 2 patients (2.8%), empyema in one (1.4%) and bronchial fistula in one (1.4%). There were no bronchial stenoses after bronchoplastic procedures, and no vascular complications after angioplastic procedures. The one-years, 3-year and 5-year survival rates for the entire group were 86.0%, 47.0%, and 29.8%, respectively. The three-year survival rates for the patients with stage I, II and III disease were 69.4%, 32.3% and 25.0%, respectively. There was no 5-year survival for patients with stage III disease, whereas for patients with stage I and II disease, the 5-year survival rates were 48.6% and 10.8%, respectively. The difference in survival was significant between stage I and II disease (P=0.0001) and between stage I and III disease (P<0.0001), but not between stage II and III (P=0.0779). Conclusion: Bronchoplastic, pulmonary arterioplastic and broncho-angioplastic procedures can be performed safely. Brochoplastic procedures offer patients with bronchogenic carcinoma a long-term result comparable to that for radical lung resections. Angioplastic and combined angio-bronchoplastic procedures should only be employed in the patients who can not tolerate a pneumonectomy due to poor carciopulmonary reserve.展开更多
Lung major resections involving bronchovascular reconstruction pose a surgical challenge due to their technical complexity and frequency.The traditional techniques to perform vascular or bronchial reconstructions thro...Lung major resections involving bronchovascular reconstruction pose a surgical challenge due to their technical complexity and frequency.The traditional techniques to perform vascular or bronchial reconstructions through multiportal video-assisted thoracoscopic surgery(VATS)approach can be applied also by uniportal VATS approach.Nevertheless,specific tools have already been developed in order to facilitate these procedures through uniportal VATS approach increasing comfort and workspace through the single port utility.These procedures must be performed just in very highly uniportal VATS trained teams and it is recommended that teams who perform these techniques previously have completed the advanced learning curve for lung major resections through uniportal VATS approach.The aim of this paper is to describe the major key points for performing most frequent bronchovascular reconstructions through uniportal VATS approach in a safe and feasible way.Operative technique is step by step described in order to safely perform most common uniportal VATS left/right side lung major bronchovascular resections and reconstructions.Specific tip and tricks are detailed in order to facilitate vascular control,bronchovascular reconstructions and unexpected bleeding control through uniportal VATS approach.展开更多
文摘Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the ＂lobular bronchi＂ with main bronchi Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.
文摘Objective: Bronchoplastic and pulmonary arterioplastic procedures have become increasingly popular in recent years as an alternative to pneumonectomy, especially for the patients with compromised cardiopulmonary reserve. Our experience with the procedures was reviewed and the operative technique, indication for the procedures, and long-term results were analyzed. Methods: From January 1977 to December 1996, 65 bronchoplasties, 4 pulmonary arterioplasties, and 3 combined broncho-angioplasties were performed for bronchogenic carcinoma. Of the 72 patients, thirty-one had stage I disease, 29 stage II and 12 stage III. Results: One patient (1.4%) died of bilateral pneumonitis after operation. Atelectasis occurred in 2 patients (2.8%), empyema in one (1.4%) and bronchial fistula in one (1.4%). There were no bronchial stenoses after bronchoplastic procedures, and no vascular complications after angioplastic procedures. The one-years, 3-year and 5-year survival rates for the entire group were 86.0%, 47.0%, and 29.8%, respectively. The three-year survival rates for the patients with stage I, II and III disease were 69.4%, 32.3% and 25.0%, respectively. There was no 5-year survival for patients with stage III disease, whereas for patients with stage I and II disease, the 5-year survival rates were 48.6% and 10.8%, respectively. The difference in survival was significant between stage I and II disease (P=0.0001) and between stage I and III disease (P<0.0001), but not between stage II and III (P=0.0779). Conclusion: Bronchoplastic, pulmonary arterioplastic and broncho-angioplastic procedures can be performed safely. Brochoplastic procedures offer patients with bronchogenic carcinoma a long-term result comparable to that for radical lung resections. Angioplastic and combined angio-bronchoplastic procedures should only be employed in the patients who can not tolerate a pneumonectomy due to poor carciopulmonary reserve.
文摘Lung major resections involving bronchovascular reconstruction pose a surgical challenge due to their technical complexity and frequency.The traditional techniques to perform vascular or bronchial reconstructions through multiportal video-assisted thoracoscopic surgery(VATS)approach can be applied also by uniportal VATS approach.Nevertheless,specific tools have already been developed in order to facilitate these procedures through uniportal VATS approach increasing comfort and workspace through the single port utility.These procedures must be performed just in very highly uniportal VATS trained teams and it is recommended that teams who perform these techniques previously have completed the advanced learning curve for lung major resections through uniportal VATS approach.The aim of this paper is to describe the major key points for performing most frequent bronchovascular reconstructions through uniportal VATS approach in a safe and feasible way.Operative technique is step by step described in order to safely perform most common uniportal VATS left/right side lung major bronchovascular resections and reconstructions.Specific tip and tricks are detailed in order to facilitate vascular control,bronchovascular reconstructions and unexpected bleeding control through uniportal VATS approach.
