Wang Shaodong, Li Yun, Wang Jun
Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
Thorac Cardiovasc Surg. 2019 Jan;67(1):73-78. doi: 10.1055/s-0038-1668596. Epub 2018 Aug 30.
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.
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.
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.
Completely VATS was a safe and effective mini-invasive procedure for pulmonary sequestration in an experienced team. Its long-term outcome was remarkable.
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。
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。
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。
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。