文章：

动脉袖状肺叶切除术：肺动脉重建类型对肺功能的影响？

Arterial Sleeve Lobectomy: Does Pulmonary Artery Reconstruction Type Impact Lung Function?

原文发布日期：13 October 2023

DOI: 10.3390/cancers15204971

类型: Article

开放获取: 是

英文摘要：

Background: The aim of this single-center retrospective cohort study was to assess the impact of arterial reconstruction technique on lung perfusion. The second objective was to ascertain the functional validity of arterial sleeve lobectomy. Method: Between January 2001 and December 2020, a total of 81 patients underwent lobectomy with pulmonary artery (PA) reconstruction for lung cancer at the University Hospital of Montpellier. After excluding patients with an incomplete postoperative pulmonary function test, we conducted a comparative analysis of the preoperative and postoperative functional outcomes (FEV1) of 48 patients, as well as the preoperative and postoperative Technetium99m scintigraphic pulmonary perfusion results of 28 patients. Then, we analyzed postoperative perfusion results according to the pulmonary artery reconstruction techniques use. Results: PA reconstruction types were as follows: 9 direct angioplasties (19%), 14 patch angioplasties (29%), 7 end-to-end anastomoses (15%), 6 prosthetic bypasses (12%), 11 arterial allograft bypasses (23%), and 1 custom-made xenopericardial conduit bypass. Regardless of the type of vascular reconstruction performed, the comparative analysis of lung perfusion revealed no significant difference between the preoperative and postoperative perfusion ratio of the remaining parenchyma (median = 29.5% versus 32.5%, respectively;p= 0.47). Regarding the pulmonary functional test, postoperative predicted FEV1significantly underestimated the actual postoperative measured FEV1by about 260 mL (11.4%) of the preoperative value. The patency rate was 96% and the 5-year overall survival was 49% for a mean follow up period of 34 months. Conclusion: Lobectomy with PA reconstruction is a valid parenchymal-sparing technique in terms of perfusion and respiratory function.

摘要翻译： 

背景：本单中心回顾性队列研究旨在评估动脉重建技术对肺灌注的影响，次要目标是明确动脉袖状肺叶切除术的功能有效性。方法：2001年1月至2020年12月期间，蒙彼利埃大学医院共有81例肺癌患者接受了肺叶切除联合肺动脉重建术。排除术后肺功能检测不完整的患者后，我们对48例患者的术前术后功能结果（FEV1）以及28例患者的术前术后锝99m肺灌注显像结果进行了比较分析。随后，根据采用的肺动脉重建技术对术后灌注结果进行分析。结果：肺动脉重建类型包括：9例直接血管成形术（19%）、14例补片血管成形术（29%）、7例端端吻合术（15%）、6例人工血管旁路术（12%）、11例同种异体动脉旁路术（23%）及1例定制异种心包管道旁路术。无论采用何种血管重建方式，肺灌注比较分析显示剩余肺实质的术前术后灌注比例无显著差异（中位数分别为29.5% vs 32.5%；p=0.47）。肺功能检测方面，术后预测FEV1较实际术后测量FEV1显著低估约260 mL（占术前值的11.4%）。平均随访34个月期间，血管通畅率为96%，5年总生存率为49%。结论：从灌注和呼吸功能角度评估，肺叶切除联合肺动脉重建是一种有效的保留肺实质技术。

原文链接：

Arterial Sleeve Lobectomy: Does Pulmonary Artery Reconstruction Type Impact Lung Function?