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肺硬化性血管瘤的手术治疗:肺叶切除术与局限性切除术对比

Surgery for Pulmonary Sclerosing Hemangioma: Lobectomy versus Limited Resection.

作者信息

Park Joon Seok, Kim Kwhanmien, Shin Sumin, Shim Hunbo, Kim Hong Kwan

机构信息

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.

出版信息

Korean J Thorac Cardiovasc Surg. 2011 Feb;44(1):39-43. doi: 10.5090/kjtcs.2011.44.1.39. Epub 2011 Feb 12.

Abstract

BACKGROUND

Pulmonary sclerosing hemangioma is a rare thoracic tumor, and pathophysiology or clinical course of this tumor is not yet fully described. Furthermore, there is no consensus on the standard operative procedure for this tumor.

MATERIAL AND METHODS

Medical records of thirty-two patients, who underwent surgical resection of pulmonary sclerosing hemangioma from 1996 to 2007, were retrospectively reviewed.

RESULTS

Nineteen patients underwent lobectomy and thirteen patients underwent limited resection. Video-assisted thoracoscopic surgery was performed in 9 patients in the latter group. Lymph node dissection was done in 21 patients, and one patient was found to have lymph node metastasis of the tumor. There was no postoperative complication, no early death and no tumor-related late mortality. The mean follow-up duration was 39.3 months (2 months~129 months), and all patients were free of local recurrence and distant metastasis during this period. There was no significant difference in patient's characteristics between the two groups, except that the mean hospital stay was shorter in limited resection group than in lobectomy group (p=0.0031).

CONCLUSION

Pulmonary sclerosing hemangioma usually requires surgical resection for both diagnosis and treatment. Limited resection can decrease hospital stay with a surgical outcome comparable to lobectomy, and may be preferred to lobectomy if sufficient resection margin can be achieved.

摘要

背景

肺硬化性血管瘤是一种罕见的胸部肿瘤,其病理生理学或临床病程尚未得到充分描述。此外,对于该肿瘤的标准手术方式尚无共识。

材料与方法

回顾性分析了1996年至2007年间接受肺硬化性血管瘤手术切除的32例患者的病历。

结果

19例行肺叶切除术,13例行局限性切除术。后一组中有9例患者接受了电视辅助胸腔镜手术。21例患者进行了淋巴结清扫,其中1例患者发现有肿瘤淋巴结转移。无术后并发症、早期死亡及肿瘤相关的晚期死亡。平均随访时间为39.3个月(2个月至129个月),在此期间所有患者均无局部复发和远处转移。两组患者的特征无显著差异,但局限性切除术组的平均住院时间比肺叶切除术组短(p = 0.0031)。

结论

肺硬化性血管瘤通常需要手术切除以进行诊断和治疗。局限性切除术可缩短住院时间,手术效果与肺叶切除术相当,如果能获得足够的切缘,可能比肺叶切除术更可取。

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