Efficacy of Lung Autotransplantation for Central Non-small Cell Lung Cancer.
10.3779/j.issn.1009-3419.2020.103.12
- Author:
Yijun MO
1
;
Lina LIN
2
;
Zhixin LI
3
;
Chenghua ZHONG
1
;
Jun YAN
1
;
Jun KUANG
1
;
Guoxiong YANG
1
;
Jianhua ZHANG
1
Author Information
1. Department of Thoracic Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen 518101, China.
2. School of Nursing, Xinhua College of Sun Yat-Sen University, Guangzhou 510520, China.
3. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China.
- Publication Type:Journal Article
- Keywords:
Lung autotransplantation;
Lung neoplasms;
Pneumonectomy;
Sleeve lobectomy
- From:
Chinese Journal of Lung Cancer
2020;23(8):673-678
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Pneumonectomy and sleeve resection are routine operations for the treatment of central non-small cell lung cancer (NSCLC), but some patients suffered of central NSCLC, whose pulmonary function is too poor to tolerate pneumonectomy, or the tumor involves the bronchus and pulmonary artery extensively,it is hard to perform bronchovascular sleeve lobectomy. The aim of this study is to assess the feasibility of lung autotransplantation in the treatment of central NSCLC.
METHODS:The clinical data of 3 cases with central NSCLC treated by lung autotransplantation was reviewed from December 2016 to December 2018. One patient underwent double sleeve resection of left upper lobe with end-to-end anastomosis of the bronchus. Because the resection of the pulmonary artery was too long to perfrom a tension-free anastomosis, the inferior pulmonary vein was cut off, then the left lower lobe was moved up for an anastomosis of the inferior pulmonary vein and the stump of the superior pulmonary vein. In the other 2 cases, left pneumonectomy was performed directly, and the upper left lobe was excised in vitro. The lower left lobe was reset to the chest after trimming and flushing and then the bronchus, pulmonary artery and pulmonary vein were anastomosed in turn.
RESULTS:The average operation time was 333 min, the average time of vascular occlusion was 86 min, the average blood loss was 450 mL, and the average hospital stay was 18.7 d; Perioperative complications included a case of bronchial obstruction, which improved after sputum aspiration through bronchofibroscope. The average follow-up period was 20 mon; One case died of cancer, one case had recurrence of anastomotic stoma and brain metastasis, one case had 4R lymph node metastasis (stable condition after chemotherapy), and one case survived without recurrence.
CONCLUSIONS:For patients with central NSCLC with extensive tumor invasion, thus inability to tolerate sleeve resection or pneumonectomy, autologous lung transplantation can preserve lung function to the greatest extent with a complete tumor resection and improve postoperative quality of life.
