Sayir Fuat, Ocakcioglu Ilhan, Şehitoğulları Abidin, Çobanoğlu Ufuk
Departmant of Thoracic Surgery, Yuzuncu Yil University, Van, Turkey.
Department of Thoracic Surgery, Marmara University, Fevzi çakmak mah. Muhsin yazıcıoğlu Cad. No:10, Üst kaynarca, Istanbul, Turkey.
Gen Thorac Cardiovasc Surg. 2019 Jun;67(6):530-536. doi: 10.1007/s11748-018-01055-6. Epub 2019 Jan 2.
Destroyed lung is whole lung destruction secondary to chronic or recurrent lung infections. This clinical condition can result in irreversible changes in the lung parenchyma. In this study, we aimed to evaluate patients undergoing pneumonectomy with a diagnosis of lung destruction in terms of surgical technique, post-operative morbidity and mortality, and long-term outcomes.
A total of 32 patients that underwent pneumonectomy due to a destroyed lung between 2005 and 2017 were retrospectively reviewed. Age, gender, presenting symptoms, etiologies, localization of the destruction, pre-operative medical history, pre- and post-operative respiratory function tests, intraoperative complications and bleeding volume, morbidity and mortality, length of hospital stay, and long-term follow-up outcomes were reviewed for each patient.
The study included 32 patients with a mean age of 31.7 ± 10.8 years. All the patients presented with persistent cough, whereas sputum production was presented by 25, hemoptysis by 18, and chest pain by 11 patients. The underlying primary diseases included nonspecific bronchiectasis in 20 (62.5%), tuberculosis in 9 (28.1%), left pulmonary hypoplasia accompanied by Bochdalek hernia in 2 (6.2%), and aspiration of a foreign body lodged in the left main bronchus in 1 (3.1%) patient. Mean operative time was 220.6 ± 40.2 min and mean perioperative bleeding was 450.9 ± 225.7 ml. Post-operative complications occurred in 14.2% of the patients, most commonly including atelectasis associated with stasis of secretions and wound site infection. Mean post-operative hospital stay was 11.8 ± 2.8 days and mean follow-up period was 35.5 ± 28.3 months. A significant clinical improvement was observed in 81.2% of the patients post-operatively.
Favorable long-term outcomes were obtained in our patients through careful patient selection and appropriate pre-operative work-up and surgical technique.
毁损肺是继发于慢性或反复肺部感染的全肺毁损。这种临床情况可导致肺实质发生不可逆变化。在本研究中，我们旨在从手术技术、术后发病率和死亡率以及长期预后方面评估诊断为毁损肺而行肺切除术的患者。
回顾性分析2005年至2017年间因毁损肺而行肺切除术的32例患者。对每位患者的年龄、性别、临床表现、病因、毁损部位、术前病史、术前和术后呼吸功能测试、术中并发症及出血量、发病率和死亡率、住院时间以及长期随访结果进行了评估。
该研究纳入了32例患者，平均年龄为31.7±10.8岁。所有患者均有持续性咳嗽，25例有咳痰，18例有咯血，11例有胸痛。潜在的原发性疾病包括20例（62.5%）非特异性支气管扩张、9例（28.1%）肺结核、2例（6.2%）伴有Bochdalek疝的左肺发育不全以及1例（3.1%）患者左主支气管异物吸入。平均手术时间为220.6±40.2分钟，平均围手术期出血量为450.9±225.7毫升。14.2%的患者发生术后并发症，最常见的包括与分泌物潴留相关的肺不张和伤口部位感染。术后平均住院时间为11.8±2.8天，平均随访期为35.5±28.3个月。81.2%的患者术后有显著的临床改善。
通过仔细的患者选择、适当的术前检查和手术技术，我们的患者获得了良好的长期预后。
