Xu Guoqiu, Fu Xiangning
Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
J Thorac Dis. 2019 Feb;11(2):535-541. doi: 10.21037/jtd.2019.01.10.
At present, we have many diagnostic methods, but there are no specific guidelines on the diagnosis and treatment of bilateral multiple pulmonary nodules (BMPNs). Clinically, one-stage video-assisted thoracic surgery (VATS) for BMPNs is not the usual treatment.
We retrospectively analyzed the clinical data of 18 patients with bilateral pulmonary nodules who underwent one-stage VATS from January 2016 to Jun 2018 in the Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, at the Huazhong University of Science & Technology. All patients were suspected of multiple primary lung cancer (MPLC) and underwent diagnostic and therapeutic one-stage VATS.
All operations were completed successfully. Duration of chest drain use was 3-15 (5.28±2.67) days. The overall duration of hospitalization after surgery was 8-19 (12.58±5.87) days. The incidence of postoperative complications was 16.67% (3 patients in all). The postoperative complications included 1 patient with subcutaneous emphysema, 1 patient with a persistent pulmonary air leak and 1 patient with the development of pleural effusion after removal of the drainage tube. There was no postoperative death.
Through rigorous preoperative assessment, it was demonstrated that one-stage VATS is safe and feasible for patients with BMPNs. Patients can avoid progression of the contralateral tumor, the trauma of the second operation, and the various burdens of medical treatment.
目前,我们有多种诊断方法,但对于双侧多发性肺结节(BMPNs)的诊断和治疗尚无具体指南。临床上,针对BMPNs的一期电视辅助胸腔镜手术(VATS)并非常规治疗方法。
我们回顾性分析了2016年1月至2018年6月在华中科技大学同济医学院附属同济医院胸外科接受一期VATS的18例双侧肺结节患者的临床资料。所有患者均怀疑为多原发性肺癌(MPLC),并接受了诊断和治疗性一期VATS。
所有手术均成功完成。胸腔引流管使用时间为3 - 15(5.28±2.67)天。术后总体住院时间为8 - 19(12.58±5.87)天。术后并发症发生率为16.67%(共3例患者)。术后并发症包括1例皮下气肿、1例持续性肺漏气和1例拔除引流管后出现胸腔积液。无术后死亡病例。
通过严格的术前评估,结果表明一期VATS对BMPNs患者是安全可行的。患者可避免对侧肿瘤进展、二次手术创伤以及各种医疗负担。