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电视辅助胸腔镜手术治疗肺隔离症:单中心35例连续病例系列

Video-Assisted Thoracoscopic Surgery for Pulmonary Sequestrations: Series of 35 Consecutive Patients in a Single Center.

作者信息

Wang Shaodong, Li Yun, Wang Jun

机构信息

Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.

出版信息

Thorac Cardiovasc Surg. 2019 Jan;67(1):73-78. doi: 10.1055/s-0038-1668596. Epub 2018 Aug 30.

Abstract

OBJECTIVE

The aim of this report is to summarize the experience of completely video-assisted thoracoscopic surgery (VATS) for pulmonary sequestration in a single center and to evaluate the long-term outcome in a larger series of patients.

METHODS

The data of 35 pulmonary sequestrations who received completely VATS consecutively in Peking University People's Hospital between January 2008 and November 2017 were retrospectively reviewed. Twenty-three females and twelve males with an average of 38 years old were included.

RESULTS

A total of 28 (80%) patients had preoperative symptoms; leading symptoms were recurrent infections (22), fever (11), hemoptysis (11), chest pain (9), and shortness of breath (4). Twenty-nine (82.9%) patients were intralobar pulmonary sequestration (22 in the left lower lobe, 6 in the right lower lobe, and 1 in the left upper lobe) and six (17.1%) patients were extralobar pulmonary sequestration. All the patients underwent VATS excision successfully, 26 underwent lobectomy, 2 underwent wedge resection, 1 underwent occlusion of the aberrant artery, and 6 underwent mass resection in all of those with extralobar pulmonary sequestration. The median surgery time and estimated blood loss was 150 (75-300) minutes and 50 (10-600) mL, respectively. There was no mortality. Only one patient suffered postoperative complication (recurrent laryngeal nerve injury). During the median follow-up period of 57 months, none of the patients presented recurrence.

CONCLUSIONS

Completely VATS was a safe and effective mini-invasive procedure for pulmonary sequestration in an experienced team. Its long-term outcome was remarkable.

摘要

目的

本报告旨在总结单中心全胸腔镜手术(VATS)治疗肺隔离症的经验,并评估更多患者的长期预后。

方法

回顾性分析2008年1月至2017年11月在北京大学人民医院连续接受全胸腔镜手术治疗的35例肺隔离症患者的数据。纳入23例女性和12例男性,平均年龄38岁。

结果

共有28例(80%)患者术前有症状;主要症状为反复感染(22例)、发热(11例)、咯血(11例)、胸痛(9例)和气短(4例)。29例(82.9%)患者为叶内型肺隔离症(左肺下叶22例,右肺下叶6例,左肺上叶1例),6例(17.1%)患者为叶外型肺隔离症。所有患者均成功接受了胸腔镜手术切除,26例行肺叶切除术,2例行楔形切除术,1例行异常动脉封堵术,6例叶外型肺隔离症患者均行肿块切除术。中位手术时间和估计失血量分别为150(75 - 300)分钟和50(10 - 600)毫升。无死亡病例。仅1例患者出现术后并发症(喉返神经损伤)。在中位随访期57个月内,无患者出现复发。

结论

对于经验丰富的团队,全胸腔镜手术是治疗肺隔离症安全有效的微创手术。其长期预后良好。

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