Takeda Shin-ichi, Koma Masaru, Kadota Yoshihisa, Funakoshi Yasunobu, Kusu Takashi, Maeda Hajime
Department of General Thoracic Surgery, Toneyama National Hospital, Toyonaka, Osaka, Japan.
Jpn J Thorac Cardiovasc Surg. 2006 May;54(5):187-92. doi: 10.1007/BF02670310.
We conducted a retrospective study of the clinical impact of a concomitant diagnostic and therapeutic procedure for patients with histologically unproven pulmonary nodules.
Between January 2001 and December 2003, we performed 150 consecutive surgical biopsy procedures for histologically indeterminate pulmonary nodules. We compared the clinical impact of the concomitant diagnostic wedge resection followed by lobectomy (U group, n=50) with that of a scheduled standard lobectomy in those with preoperatively proven clinical stage I lung cancer during the same period (C group, n=60).
There were no significant differences in dichotomous variables, whereas we found significant differences in tumor size, operative time and blood loss between the 2 groups. Complication developed in 9 in the U group and 3 in the C group (p=0.030). Hospital mortality was 2% in the U group and 0% in the C group (p=0.11).
Morbidity and mortality following a concomitant diagnostic and therapeutic procedure in patients with preoperatively undiagnosed lung cancer was acceptable, however, staged operations should be indicated for patients with considerable co-morbidity.
我们对组织学诊断未明确的肺结节患者进行了一项诊断与治疗同步进行的临床影响的回顾性研究。
在2001年1月至2003年12月期间，我们对150例组织学诊断不明确的肺结节患者连续进行了手术活检。我们将同期对术前已证实为临床I期肺癌患者进行的诊断性楔形切除术后再行肺叶切除术（U组，n = 50）与计划进行的标准肺叶切除术（C组，n = 60）的临床影响进行了比较。
两组在二分变量方面无显著差异，但我们发现两组在肿瘤大小、手术时间和失血量方面存在显著差异。U组有9例发生并发症，C组有3例发生并发症（p = 0.030）。U组的医院死亡率为2%，C组为0%（p = 0.11）。
术前未诊断的肺癌患者进行诊断与治疗同步进行后的发病率和死亡率是可以接受的，然而，对于合并症较多的患者应采用分期手术。
