The first case in the west!Huaxi expert team uses "minimally invasive" to carry lung transplantation, with only more than 10 cm in wounds

Recently, under the leadership of Professor Liu Lunxu and Professor Pu Qiang of the West China Hospital of Sichuan University, under the collaboration of thoracic surgery, respiratory and critical medicine department, anesthesiology, operating room, ICU, and rehabilitation department A case of "thoracoscopic auxiliary small incision of the same kind of albumal right lung transplantation".

After consulting related documents and reports, this is the first time that the western region has practiced the concept of "minimally invasive" in the field of lung transplantation, and the lung transplantation is used to use thoracoscopy assisted small incisions.

1. How powerful is this operation?

3 sentences clear

● In this case, the patient did not use ECMO during the patient's surgery. The surgery lasted 5.5 hours and the bleeding was only 120ml;

● The next day after surgery, get out of the ventilator and turn out the ICU on the second day;

● Through rehabilitation exercise, oxygen walking activities can be removed on the 5th after surgery, and the hospital was discharged smoothly 14 days after the operation.

Patient's postoperative physical rehabilitation training (day 4 after surgery)

Professor Pu Qiang, a lung transplantation team at the West China Hospital of Sichuan University, introduced that the patient was a 48 -year -old man who began to appear repeated cough and sputum two years ago, accompanied by asthma.

After visiting the Huaxi Hospital, he was diagnosed with special lung fibrosis, and began to take anti -pulmonary fibrosis drugs to control the condition.

However, about 7 months ago, the patient's condition increased significantly, and his physical strength dropped rapidly. He was panting in just 100 meters by walking, and he could not climb the building and do other physical activities. The quality of life was difficult to take care of himself. Can't control the condition.

• For respiratory failure caused by the progress of lung fibrosis, lung transplantation is currently the only effective treatment method.

The lung transplantation team adopts "minimally invasive" surgery, and the medical rehabilitation team practice the concept of "fast recovery after surgery", which not only greatly reduces surgical trauma (the traditional operating chest incision is relatively large, and minimally invasive surgical only requires more than 10 cm ), And significantly shortened the ICU retention time and hospitalization time, saving medical expenses.

(Surgical incision, thoracoscopy assisted small incision, single lung transplantation)

(Conventional double lung transplant open chest incision, picture source: uptodate ©)

After surgery, the patient's activity tolerance was significantly improved compared to the before surgery, and the quality of life was greatly improved.

2. What kind of patients are suitable for lung transplantation?

Lung transplantation is a severe lung disease after various other treatment. When there is no other optional treatment, lung transplantation surgery can be considered when there are no other optional treatment methods.

There are mainly these types of diseases that need to be transplanted:

Chronic obstructive pulmonary disease and/or qi emphysema

The number of chronic pulmonary disease in my country has exceeded 100 million, and the incidence of chronic pulmonary blockage of people over the age of 40 is as high as 13.6%. And the older the patient, the higher the incidence, and the higher incidence than women.

Slow -blocking the lungs lacks a cure means, and conventional treatment can only delay the development of the disease.

Pulmonary Fibrosis

In particular, the special pulmonary fibrosis, the patient's natural survival period after acute aggravation is short, and lung transplantation needs to be considered as soon as possible.

Bronchial dilatation, pulmonary cystic fibrosis

Primary pulmonary hypertension

Pneumoconiosis

Other lung diseases

Including lung lymphatic fibroid disease, lung Langehhaus tissue cell hyperplasia, congenital heart disease combined with Eisenmanig syndrome, and other rare diseases such as nodular diseases or conditions may also consider lung transplantation.

Patients who meet the above are recommended to be transplanted and treated as soon as possible.

3. What steps do I need to go through the lungs in West China Hospital?

1. Consult the doctor

The number of doctors of breathing and critical medical department and thoracic surgery can be hung directly.

2. Multi -disciplinary team evaluation

Because the lung source is very difficult to obtain (generally the lung source waiting time is 3 to 6 months), patients who are preparing to do lung transplantation generally go through 10 days to two weeks detailed preoperative evaluation.

术前评估检查有40多项，肺移植团队将对患者进行系统的生理及心理的评估，包括如下检查：胸部CT、肺功能、心电图、超声心动图、血液相关检查（血型、移植配型、 Related infectious disease preliminary antibodies and nucleic acid detection, important organ detection, etc.), exercise ability assessment, bone density detection, and other examinations related to the health status of patients.

After a comprehensive assessment of multi -disciplinary teams, patients who believe that the indication is accurate, can withstand surgery, and good rehabilitation prospects to lie on the operating table.

(Two weeks after surgery, the patient recovered discharge)

3. Regular follow -up

After the assessment, doctors and nurses will regularly follow up and guide patients.

-The end-

The lungs are the lowest organs in my country, which is related to the serious scarcity of organ donor. I hope more people can join the career of organ donation ~

"Popular Science Doctor in this issue"

Text/Edit | Dravian | Yunyun

Produced | Huang Liqin Review | Lan Lan Lan Lan

Picture Source | Huaxi Hospital of Sichuan University, 123RF, etc.

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