器官移植2025，Vol.16Issue(6)：907-913,7.DOI:10.12464/j.issn.1674-7445.2025190
肺移植外科手术中右肺减容方式探讨
Discussion on right lung volume reduction techniques in lung transplantation surgery
摘要
Abstract
Objective To investigate the clinical effects of different right lung volume reduction techniques when the donor lung is oversized and mismatched with the recipient.Methods Clinical data of 10 recipients who underwent right lung volume reduction lung transplantation at the First Affiliated Hospital of Xi'an Jiaotong University from October 2022 to June 2024 were collected,including gender,age,primary disease type,and type of transplantation.A retrospective analysis was performed on postoperative complications within 90 days,duration of mechanical ventilation,hospital stay,and survival status to explore the impact of different volume reduction techniques on the survival rate of lung transplant recipients.Results A total of 10 right lung volume reduction recipients were included in this study,with 2 cases of upper lobe reduction,7 cases of middle lobe reduction,and 1 case of lower lobe reduction.Three recipients developed airway complications(one each with upper,middle,and lower lobe reduction).The 30-day survival rate was 90%and the 1-year survival rate was 70%.One recipient with upper lobe reduction died of septic shock during the perioperative period,one with lower lobe reduction died of airway anastomotic fistula 2 months after surgery,and one with middle lobe reduction died of renal insufficiency 1 year after surgery.All 7 recipients with middle lobe reduction successfully passed the perioperative period,with one case of airway anastomotic stenosis(1/7).The average duration of mechanical ventilation was 71 hours,and the average hospital stay was 26 days.The 30-day survival rate was 7/7,and the 1-year survival rate was 6/7.Conclusions Middle lobe reduction in right lung transplantation surgery has the advantages of low incidence of airway complications,good safety,and minimal loss of lung function,and may be a better right lung volume reduction option with potential for application.关键词
肺移植/外科减容/气道残端瘘/肺叶移植/体质量指数/慢性阻塞性肺疾病/特发性肺纤维化/生存率Key words
Lung transplantation/Surgical volume reduction/Airway stump fistula/Lobar transplantation/Body mass index/Chronic obstructive pulmonary disease/Idiopathic pulmonary fibrosis/Survival rate分类
临床医学引用本文复制引用
王泓懿,李益行,冯锦腾,赵恒,张言鹏,高山,王绩钊,李硕,张广健..肺移植外科手术中右肺减容方式探讨[J].器官移植,2025,16(6):907-913,7.基金项目
四大慢病重大专项(2024ZD0528600、2024ZD0528601) （2024ZD0528600、2024ZD0528601）
陕西省重点研发计划(S2024-YF-YBSF-0923) （S2024-YF-YBSF-0923）
