We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Technik der Manschettenresektion am Bronchial- und Lungengefäßbaum.
- Authors
Branscheid, D.; Beshay, M.
- Abstract
Sleeve resections of the lungs have affected the oncologic radicality, parenchyma and lung function-saving resections and extended the indications for operations in thoracic surgery. Whenever lung amputations can be avoided by bronchoplastic and/or angioplastic procedures with the same radicality, sleeve resection should be performed. In centrally located distinct malignomas, intraluminal tumor growth (T3) infiltrations of peribronchial or extrabronchial areas, the lobular ostia and the pulmonary artery (T2/T3) as well as lymph node involvement (N1/N2), these procedures give a better qualitative survival and lower morbidity and mortality rates. Broncoscope-guided localization of a double lumen tube and routine anesthesia monitoring are mandatory. Before performing sleeve resections a complete lymph node dissection should be done without denuding the area of the anastomosis and sparing the bronchial arteries. Preoperative endoscopic biopsies, knowledge of the topography and mobilization of the vascular and bronchial tree, subtile operation techniques, perioperative and postoperative videobronchoscopic guidance as well as intraoperative frozen sections and a tension-free and smooth anastomosis, avoid postoperative complications. Depending on the blood supply of the bronchial tree a vascularized flap is indicated. Operability can therefore be achieved in elderly patients with limited pulmonary function, particularly those under adjuvant or neoadjuvant therapy who are no longer suitable for pneumonectomy.
- Subjects
SURGICAL excision; THORACIC surgery; TUMOR growth; ANESTHESIA; LYMPH nodes; BIOPSY
- Publication
Der Chirurg, 2013, Vol 84, Issue 6, p459
- ISSN
0009-4722
- Publication type
Article
- DOI
10.1007/s00104-012-2428-1