肺转移切除术;20 例患者的分析和临床概况

Egemen Döner
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摘要

有研究显示,与多器官转移的病例相比,对原发肿瘤已得到控制且仅有肺转移的患者实施转移灶切除手术,可在完全手术切除后获得更好的生存率。在我们的研究中,我们回顾性地分享了转移灶切除手术的经验及其对生存的影响。在我们的诊所,我们对2010年至2020年间因肺部发现转移瘤而接受手术的20名患者(12名男性,8名女性;平均年龄49岁)进行了回顾性研究。根据患者的年龄、性别、原发肿瘤病理、无病时间、放射学和手术情况对其进行了判定。根据检测到的转移病灶数量、手术类型和随访时间进行评估。对所有患者进行了呼吸功能测试。原发肿瘤得到控制的肺部孤立性病变患者,如果心肺状况适合切除,则接受切除手术。20 名患者中有 3 人接受了视频辅助胸腔镜手术(VATS),另外 17 人接受了开胸手术,总共进行了 28 次转移灶切除手术。手术前发现的结节数量为 39 个,而手术中共切除了 51 个结节。手术中未发现重大并发症。我们的患者中有 9 人在术后 5 年内因广泛转移而死亡,但有 11 名患者在随访中未发现肺转移。众所周知,转移灶切除术对原发肿瘤得到控制的孤立肺转移病例的生存有积极影响。由于在评估结节数量时可能会漏掉放射学检查结果,因此开放手术治疗和数字触诊在转移灶切除术中仍然非常重要。
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Pulmonary Metastasectomy; Analyse and Clinical Overview of 20 Patients
It has been revealed that metastasectomy surgery performed on patients whose primary tumor is under control and who have only lung metastases can show better survival after complete surgical resection compared to cases with multiple organ metastases. In our study, we retrospectively shared our experience with metastasectomies and their impact on survival. In our clinic, 20 patients (12 men, 8 women; average age 49 years) who were operated on due to metastasis detected in the lung between 2010 and 2020 were retrospectively examined. Patients were determined according to age, gender, primary tumor pathology, disease-free time, radiologically and surgically. It was evaluated according to the number of metastatic lesions detected, the type of operation and the follow-up period. Respiratory function tests were performed on all patients. Patients with isolated pulmonary lesions whose primary tumors were under control underwent resection if their cardiopulmonary status was suitable for resection. Three of the twenty patients underwent video-assisted thoracoscopic surgery (VATS), and the other 17 patients underwent open thoracotomy, for a total of 28 metastasectomy operations. While the number of nodules detected before the operation was 39, a total of 51 nodules were excised during the operation. No major complications were observed. While 9 of our patients died due to widespread metastases within the 5-year postoperative period, 11 patients are being followed up disease-free without pulmonary metastases. It is known that metastasectomy positively affects survival in cases with isolated pulmonary metastases whose primary tumor is under control. The possibility of missing radiological findings when evaluating the number of nodules still makes the importance of open surgical treatment and digital palpation current in metastasectomy.
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