背景与目的肺癌被认为是肺移植的相对禁忌症,但随着移植技术的进步,此类非常规疾病也被纳入肺移植适应症.本文通过报道l例双肺移植成功治疗双侧肺癌男性患者的病例,并结合相关文献复习,探讨肺移植治疗肺癌的适应症及疗效.方法2010年l0月21日南京医科大学附属无锡市人民医院肺移植组为1例42岁男性患者成功进行了序贯式双肺移植,该患者术前胸部CT及PET-CT示双肺多发斑片状及团块样浸润阴影,纵隔淋巴结不肿大,其余部位未见转移.术后病理证实为粘液型细支气管肺泡癌,分期T4N0M0,Ⅲb期.结果患者术后予常规三联免疫抑制,抗细菌、真菌、病毒等一系列治疗,并于术后66天恢复良好出院并定期随访,术后6个月随访时肺功能良好,未见明显转移征象.结论对于某些合适的肺癌患者,肺移植是一个有效的治疗方法.%Background and objective Lung carcinoma is a relative contraindication for lung transplantation (LTx). The improvement of this procedure may successfully treat novel end-stage pulmonary diseases. In the present study, we reported one case of bilateral LTx (BLT) in a young man with bilateral lung carcinoma and reviewed related literature to investigate patient selection and curative effect. Methods A 42-year-old male patient underwent BLT on October 21,2010 in our hospital. Preoperative chest CT and PET-CT showed bilateral multiple nodules and mass without positive lymph nodes or extrapulmonary metastasis. Bronchioloalveolar carcinoma was identified histologically (T4N0M0, stage IIIb). Results Routine therapies were performed postoperatively. The patient was discharged on post-operative day 66. There was no clinical or radiologic evidence of the recurrence of lung carcinoma in his latest follow-up of 6 months postoperatively. Conclusion LTx may be proposed as an efficient therapeutic option in selected patients of lung carcinoma.
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