Zheng Xi, Huang Yue, Gou Junhe, Zhu Daxing, Zhou Qinghua
Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 611135, China.
West China Medical School, Sichuan University, Chengdu 610041, China.
J Thorac Dis. 2018 Jan;10(1):E20-E23. doi: 10.21037/jtd.2017.12.21.
Surgery is one of the first-line treatments for thymic carcinoma. Middle lobe syndrome which is irresponsive to conservative therapies also calls for surgical intervention. We reported the case of a 65-year-old male who was diagnosed with coexistent thymic carcinoma and non-obstructive middle lobe syndrome. Before the operation, we took measures including repeated sputum examination, physical therapy, postural sputum drainage and bronchodilator inhalation. After removal of the mediastinal neoplasm, venous antibiotics were used to prevent pneumonia. The preexistent cough with purulent expectoration still lasted, but no pulmonary infection occurred. Our report indicates that middle lobe syndrome may not increase respiratory complications after midline sternotomy if it receives proper treatments before the operation. For patients with concurrent thymic carcinoma and persistent middle lobe atelectasis, the thymic tumor might be treated with priority to increase the chance of complete resection.
手术是胸腺癌的一线治疗方法之一。对保守治疗无反应的中叶综合征也需要手术干预。我们报告了一例65岁男性患者，该患者被诊断为同时患有胸腺癌和非阻塞性中叶综合征。术前，我们采取了包括反复痰检、物理治疗、体位排痰和吸入支气管扩张剂等措施。切除纵隔肿瘤后，使用静脉抗生素预防肺炎。术前存在的咳嗽伴脓性咳痰仍持续存在，但未发生肺部感染。我们的报告表明，如果在手术前得到适当治疗，中叶综合征在正中胸骨切开术后可能不会增加呼吸并发症。对于同时患有胸腺癌和持续性中叶肺不张的患者，可能应优先治疗胸腺肿瘤以增加完全切除的机会。
