oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2020-19-1-22-30oncotomsk-1318Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESРЕКОНСТРУКТИВНЫЕ ВМЕШАТЕЛЬСТВА НА ЛЕГОЧНОЙ АРТЕРИИ ПРИ ОРГАНОСОХРАНЯЮЩИХ ОПЕРАЦИЯХ В ХИРУРГИИ РАКА ЛЕГКОГОPULMONARY ARTERY RECONSTRUCTION IN ORGAN-PRESERVING SURGERIES FOR LUNG CANCERhttps://orcid.org/0000-0002-3322-4284КиршинА. А.KirshinA. A.

заведующий онкологическим отделением хирургических методов лечения № 1; заочный аспирант кафедры факультетской хирургии

SPIN‑код: 3854‑0649. AuthorID (РИНЦ): 1044593Россия, 426009, г. Ижевск, ул. Ленина, 102

Россия, 426034, г. Ижевск, ул. Коммунаров, 281

MD, Head of Oncology Department

102, Lenina Street, 426009, Izhevsk, Russia

281, Kommunarov Street, 426034, Izhevsk, Russia

kirshinalex80@mail.ruhttps://orcid.org/0000-0002-5334-6481БурмистровМ. В.BurmistrovM. V.

доктор медицинских наук, заместитель главного врача по медицинской части; профессор кафедры онкологии, радиологии и паллиативной медицины  Россия, 420064, г. Казань, Оренбургский тракт, 138

Россия, 420029, г. Казань, Сибирский тракт, 29

 

MD, Deputy Chief Physician; Professor of the Department of Oncology, Radiology and Palliative Medicine

138, Orenburgsky Trakt, 420064, Kazan, Russia

29, Sibirsky Trakt, 420029, Kazan, Russia

burma71@mail.ruБУЗ Удмуртской Республики «Республиканский клинический онкологический диспансер им. С.Г. Примушко» Министерства здравоохранения Удмуртской Республики, ФГБОУ ВО «Ижевская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияS.G. Primushko Republic Clinical Cancer Center, Ministry of Health of the Udmurt Republic, Izhevsk State Medical Academy, Ministry of Health of the Russian FederationRussian FederationГАУЗ «Республиканская клиническая больница» Министерства здравоохранения Республики Татарстан, Казанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRepublic Clinical Hospital, Ministry of Health of the Republic of Tatarstan, Kazan State Medical AcademyRussian Federation2020290220201912230Copyright © Киршин А.А., Бурмистров М.В., 20202020Киршин А.А., Бурмистров М.В.Kirshin A.A., Burmistrov M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/1318

Целью исследования является изучение особенностей реконструктивных вмешательств на легочной артерии в органосохраняющей хирургии рака легкого в аспекте безопасности, функциональной целесообразности и качества жизни.

Материал и методы

Материал и методы. С 2009 г. по декабрь 2016 г. в исследование были включены 183 больных с немелкоклеточным раком легкого (156 мужчин и 27 женщин, средний возраст – 58,4 ± 12,3 года). В 92 случаях выполнены ангиопластические лобэктомии, в 91 случае – пневмонэктомии.

Результаты

Результаты. Интраоперационных осложнений и летальных исходов не было. Послеоперационные осложнения после ангиопластической лобэктомии возникли в 23 (25 %), после пневмонэктомии – в 36 (39,6 %) случаях. Летальность после ангиопластической лобэктомии составила 3 (3,3 %), после пневмонэктомии – 7 (7,7 %) случаев. При анализе параметров функции внешнего дыхания установлено, что после ангиопластической лобэктомии ОФВ1 через 1 год после операции снизился на 0,69 (27 %) л, ЖЕЛ – на 1,17 (32,9 %) л, ФЖЕЛ – на 0,64 (20,5 %) л. После удаления легкого динамика снижения данных показателей составила 1,02 (42 %); 1,53 (43,8 %); 1,24 (40,3 %) л соответственно. При анализе 8 основных параметров опросника SF36 выявлено, что после ангиопластической лобэктомии средние значения данных показателей были выше, чем после пневмонэктомии.

Заключение

Заключение. Реконструктивные вмешательства на легочной артерии при органосохраняющих операциях, выполненных по поводу рака легкого, позволяют получить приемлемый непосредственный результат, редуцировать негативные функциональные последствия по сравнению с полным удалением легкого и обеспечить максимальное сохранение качества жизни пациентов.

The purpose of the study was to analyze immediate outcomes of pulmonary artery reconstruction for lung cancer in terms of safety, functional feasibility and quality of life.

Material and methods

Material and methods. From 2009 to 2016, the study included 183 patients with non-small cell lung cancer (156 men and 27 women, median age: 58.4 ± 12.3 years). Angioplasty lobectomy was performed in 92 cases and pneumonectomy in 91 cases.

Results

Results. There were no intraoperative complications. Postoperative complications were observed in 23 (25 %) cases after angioplasty lobectomy and in 36 (39.6 %) cases after pneumonectomy. Three (3.3 %) patients died after angioplasty lobectomy and 7 (7.7 %) after pneumonectomy. When comparing the parameters of the external respiration function after surgery, it was found that after angioplastic lobectomy, FEV1 decreased by 0.69 (27 %) liters 1 year after surgery, VC decreased by 1.17 (32.9 %) liters, and FLC reduced by 0,64 (20.5 %) liters. After removal of the lung, reduction in these parameters was, respectively, 1.02 (42 %); 1.53 (43.8 %); 1.24 (40.3 %) liters. The main SF36 questionnaire parameters were higher in the group of angioplasty lobectomy than in the group of pneumonectomy.

Conclusion

Conclusion. Pulmonary artery reconstruction for lung cancer is safe, with low morbidity and mortality. This technique is an effective alternative to pulmonectomy in lung cancer surgery. 

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The authors declare that there are no conflicts of interest present.