解剖性肺切除手术会导致左心室搏出量下降。

IF 2.3 3区 医学 Q3 ONCOLOGY Thoracic Cancer Pub Date : 2024-08-22 DOI:10.1111/1759-7714.15434
Sachie Koike, Takayuki Shiina, Keiichirou Takasuna
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引用次数: 0

摘要

研究目的肺切除术对心脏功能的影响已有报道,以往的研究主要集中于右心室(RV)功能障碍。由于很少有研究分析肺切除术引起的左心室血流动力学变量的变化,我们旨在研究解剖性肺切除术引起的围手术期左心室每搏量(LVSV)的变化:我们招募了 61 名接受肺解剖学切除术和围手术期 LVSV 监测的患者。Flo Trac 系统用于动态监测。我们研究了肺切除术后 LVSV 的变化以及影响这些变化的因素。我们还调查了导致这些变化的手术过程:大多数患者(38 人,62.2%)在解剖性肺切除术后 LVSV 下降。影响这种变化的手术方法有:(a)在背侧部分手术(如右上肺叶切除术的主要裂隙分割、左上肺叶切除术的 A1 + 2c 和 A4 + 5 分割)前绑扎上肺静脉(SPV;右侧:V1-3);(b)分割 SPV(右侧:V1-3、V4 + 5);(c)分割 A6-10(在下肺叶切除术中);以及(d)完成所有血管的分割:结论:大多数患者的 LVSV 下降是由于上述术中操作的解剖性肺切除所致。
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Left ventricular stroke volume decreases due to surgical procedures of anatomical lung resection.

Objectives: The influence of lung resection on cardiac function has been reported, and previous studies have mainly focused on right ventricular (RV) dysfunction. As few studies have analyzed changes in left ventricular hemodynamic variables caused by lung resection, we aimed to investigate the perioperative changes in left ventricular stroke volume (LVSV) caused by anatomical lung resection.

Methods: We enrolled 61 patients who underwent anatomical lung resection and perioperative LVSV monitoring. The Flo Trac system was used for dynamic monitoring. We investigated changes in LVSV after lung resection and the factors that affected these changes. The operative procedures that contributed to these changes were also investigated.

Results: LVSV decreased after anatomical lung resection in the majority of patients (n = 38, 62.2%). Operative procedures affecting this change were (a) taping the superior pulmonary vein (SPV; right: V1-3) before dorsal part procedure (e.g., major fissure division of right upper lobectomy, A1 + 2c, and A4 + 5 division of left upper lobectomy); (b) division of the SPV (right: V1-3, V4 + 5); (c) division of A6-10 (in lower lobectomy); and (d) finish division of all vessels.

Conclusions: LVSV decrease was caused by anatomical lung resection in the majority of patients owing to the intraoperative procedures described above.

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来源期刊
Thoracic Cancer
Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM
CiteScore
5.20
自引率
3.40%
发文量
439
审稿时长
2 months
期刊介绍: Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.
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