Şükrü DİLEGE, Göksel KALAYCI, Serhan TANJU, Alper TOKER

Akciğer kanserinin komplet rezeksiyonunda üç rekonstrüksiyon, dört anastomoz: Bronkovasküler sleeve lobektomi ve vena kava superior rezeksiyonu

Yetmiş sekiz yaşındaki bir erkek hastaya akciğer kanseri nedeniyle sağ üst çift sleeve lobektomi, superior vena kava rezeksiyonu ve prostetik greft ile rekonstrüksiyon uygulandı. Superior vena kava rezeksiyonu sonrasında politetraflouroetilen greft sağ innominat ven-sağ atriyum arasına interpoze edildi. Sağ üst loba bronkovasküler sleeve rezeksiyon uygulandıktan sonra intermediate bronş sağ ana bronşa, intermediate pulmoner arter ana pulmoner artere anastomoze edildi. Ameliyat sonrası dönemi sorunsuz geçiren hasta sekizinci günde taburcu edildi. Hasta iki yıldır sağlıklı olarak takip edilmektedir.

Complete resection of lung cancer with three reconstructions and four anastomoses: Bronchovascular sleeve lobectomy and resection of the superior vena cava

A 78-year-old male patient with lung cancer underwent complete resection with a right double-sleeve upper lobectomy and superior vena cava (SVC) resection. After resection of the SVC, reconstruction was made with the use of a polytetraflouroethylene graft between the right innominate vein and the right atrium. After bronchovascular sleeve resection of the right upper lobe, the intermediate bronchus and intermediate pulmonary artery were anastomosed to the right main bronchus and interlobar pulmonary artery, respectively. He was discharged on the eighth day after an uneventful postoperative period and had no problem during a two-year follow-up.

PDF

___

1) Martini N, Yellin A, Ginsberg RJ, Bains MS, Burt ME, McCormack PM, et al. Management of non-small cell lung cancer with direct mediastinal involvement. Ann Thorac Surg 1994;58:1447-51.
2) Spaggiari L, Regnard JF, Magdeleinat P, Jauffret B, Puyo P, Levasseur P. Extended resections for bronchogenic carcinoma invading the superior vena cava system. Ann Thorac Surg 2000;69:233-6.
3) Sagawa M, Sakurada A, Fujimura S, Sato M, Takahashi S, Usuda K, et al. Five year survivors with resected pN2 nonsmall cell lung carcinoma. Cancer 1999;85:864-8.
4) Keller SM, Vangel MG, Wagner H, Schiller JH, Herskovic A, Komaki R, et al. Prolonged survival in patients with resected non-small cell lung cancer and single-level N2 disease. J Thorac Cardiovasc Surg 2004;128:130-7.
5) Doddoli C, Rollet G, Thomas P, Ghez O, Seree Y, Giudicelli R, et al. Is lung cancer surgery justified in patients with direct mediastinal invasion? Eur J Cardiothorac Surg 2001;20: 339-43.
6) Sekine Y, Yasufuku K, Motohashi S, Fujisawa T. Triple reconstruction of pulmonary artery, superior vena cava and bronchus for lung cancer. Interact Cardiovasc Thorac Surg 2006;5:509-10.