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肺曲菌球的外科治疗——改良保守手术

[Surgical treatment of pulmonary aspergilloma--with modified conservative operation].

作者信息

Otsuka T, Imura Y, Yamamoto H, Kobayashi T

机构信息

Department of Thoracic Surgery, Tokyo Metropolitan Fuchu Hospital, Japan.

出版信息

Kekkaku. 1992 May;67(5):369-76.

PMID:1597934
Abstract

During the past 10 years 26 patients were operated on for pulmonary aspergilloma (20 males and six females, mean age of 55.8 years). Lung resections were performed on 13 cases (Group 1). Conservative operations were performed on the remaining cases, including one bilateral operation case (Group 2). New paragraph. The operative techniques in Group 1 were: lobectomy 11 cases of lobectomy, one case of partial resection; and one case of segmental resection. The operative techniques for Group 2 were; five cases of thoracoplasty and cavernoplasty; three cases of thoracoplasty plus cavernoplasty and muscle flap; three cases of thoracoplasty and muscle flap; one case of thoracoplasty and air-plombage; and two cases of cavernoplasty. A second operation was required in four and seven cases in Groups 1 and 2, respectively, and a third operation in two and four cases respectively. The conservative technique was used in all of additional operations required. The mean operation time and amount of blood loss were 262 min and 1,943 ml for Group 1 and 170 min and 918 ml for Group 2-being shorter and lesser for Group 2. Both the operation time and blood loss were reduced during the second and third operations. Reduction of %VC after the first operation was also less remarkable for Group 2 (-9.6%, No = 9). The advantage of using a conservative technique is that successful results can be expected without insult to the hilus and mediastinal surface in cases with compromised pulmonary functions, or in those cases which pneumonectomy or resection is difficult because of the risk of massive bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在过去10年中,26例患者接受了肺曲菌球手术(20例男性和6例女性,平均年龄55.8岁)。13例患者进行了肺切除术(第1组)。其余患者进行了保守手术,包括1例双侧手术病例(第2组)。新段落。第1组的手术技术为:11例肺叶切除术、1例部分切除术和1例节段切除术。第2组的手术技术为:5例胸廓成形术和空洞成形术;3例胸廓成形术加空洞成形术和肌瓣;3例胸廓成形术和肌瓣;1例胸廓成形术和空气填充术;2例空洞成形术。第1组和第2组分别有4例和7例需要进行二次手术,分别有2例和4例需要进行三次手术。所有额外需要的手术均采用保守技术。第1组的平均手术时间和失血量分别为262分钟和1943毫升,第2组为170分钟和918毫升,第2组更短且更少。二次手术和三次手术期间的手术时间和失血量均减少。第2组第一次手术后%VC的降低也不太明显(-9.6%,n = 9)。使用保守技术的优点是,对于肺功能受损的病例,或因大出血风险而难以进行肺切除术或切除术的病例,在不损伤肺门和纵隔表面的情况下,可以预期获得成功的结果。(摘要截断于250字)

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