Whitson Bryan A, Maddaus Michael A, Andrade Rafael S
Department of Surgery, Section of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA.
Am Surg. 2007 Mar;73(3):279-80.
Invasive pulmonary aspergillosis (IPA) is associated with a high mortality rate in immunocompromised patients. Surgery has a therapeutic role for selected patients when the main objective is to achieve infection control with minimal lung resection. Large or deep-seated lesions may require an anatomic resection such as segmentectomy, lobectomy, or pneumonectomy. Thoracoscopic lobectomy has been described as a treatment of localized IPA; however, thoracoscopic anatomic segmentectomy has not been reported until now. Herein, we describe a case of thoracoscopic lingulectomy for localized IPA in an immunocompromised patient: this operation minimized the delay in resuming therapy for the patient's underlying acute myeloid leukemia. Video-assisted thoracoscopic segmentectomy can be safely performed for localized IPA.
侵袭性肺曲霉病(IPA)在免疫功能低下患者中死亡率较高。对于部分患者,当主要目标是以最小限度的肺切除实现感染控制时,手术具有治疗作用。较大或深部病变可能需要进行解剖性切除,如肺段切除术、肺叶切除术或全肺切除术。胸腔镜肺叶切除术已被描述为局限性IPA的一种治疗方法;然而,迄今为止,胸腔镜解剖性肺段切除术尚未见报道。在此,我们描述一例免疫功能低下患者因局限性IPA行胸腔镜舌叶切除术的病例:该手术最大限度地减少了患者潜在急性髓系白血病恢复治疗的延迟。电视辅助胸腔镜肺段切除术可安全地用于局限性IPA的治疗。