[Pulmonary resection for metastatic gallbladder carcinoma by thoracoscopic surgery--report of a case].
[Pulmonary resection for metastatic gallbladder carcinoma by thoracoscopic surgery--report of a case].
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胸腔镜肺切除术治疗转移性胆囊癌一例报告
DOI：
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发表时间：
1994
期刊：
影响因子：
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通讯作者：
H. Serizawa
中科院分区：
文献类型：
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作者：
I. Suzuki;K. Oho;K. Tamura;Y. Ohtani;Y. Tanaka;H. Serizawa
一位58岁男性因胆囊癌直接侵犯肝脏在另一家医院接受胆囊切除术和部分肝切除术后11个月入住我院。胸部X光片在肺部发现了三个圆形的异常阴影，但患者既没有被诊断也没有被治疗。入院时，我们确认了三个小病灶。术前经纤维支气管镜肺活检及经皮肺穿刺活检确诊为肺腺癌。在使用Unibent插管进行单肺麻醉期间，使同侧肺塌陷，并使用我们自己设计的柔性纤维胸腔镜和可重复使用的胸腔手术端口进行胸腔镜手术。通过胸内ENDO-DIA对肺部病变进行楔形切除。一个高分化腺癌定义为胆囊癌转移的诊断切除标本。胸腔镜手术似乎是一种安全，有效和较少病态的开胸手术的替代程序，精心挑选的患者周围肺部病变。进一步的评价和前瞻性研究表明。
A 58-year-old male was admitted to our hospital 11 months after undergoing a cholecystectomy and partial hepatectomy for carcinoma of the gallbladder with direct invasion of the liver at another hospital. Three round, abnormal shadows had been detected in the lungs by chest roentgenogram, but the patient had neither been diagnosed nor treated. On admission to our hospital, we confirmed three small lesions. Before operative procedure, the lung lesions were diagnosed as adenocarcinoma by transbronchial lung biopsies via fiberoptic bronchoscope and percutaneous needle biopsies. The ipsilateral lung was collapsed during one-lung anesthesia with a Unibent tube, and thoracoscopic surgery was performed using a flexible thoraco-fiberscope and reusable thoracic surgiports of our own design. A wedge resection of the pulmonary lesion was performed by intrathoracic ENDO-DIA. A well differentiated adenocarcinoma defined as a metastasis of gallbladder carcinoma was diagnosed by resected specimen. Thoracoscopic surgery appears to be a safe, effective and less morbid alternative procedure to thoracotomy for carefully selected patients with peripheral pulmonary lesions. Further evaluation and prospective studies are indicated.