Ma Han, Wang Jun, Ma Xiao, Zheng Shiying, Ma Haitao, Ge Jinfeng
Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Department of Haematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
J Thorac Dis. 2019 Jul;11(7):2839-2845. doi: 10.21037/jtd.2019.07.13.
Invasive pulmonary fungal infection in haematological patients sometimes was a difficult problem in diagnosis and treatments. This retrospective study was intended to assess the outcomes of video-assisted thoracoscopic surgery (VATS) in the treatments of this problem.
From January 2011 to December 2017, a total of 51 haematological patients underwent VATS for invasive pulmonary fungal infection. We collected and then analyzed potential factors including general conditions, types of haematological diseases, preoperative clinical symptoms, surgical procedures, length of postoperative hospital stay, incidence of postoperative complications and postoperative follow-ups.
Of the 51 patients, 32 patients underwent video-assisted thoracoscopic wedge resection (62.7%), 6 patients underwent video-assisted thoracoscopic segmentectomy (11.8%) and 13 patients underwent video-assisted thoracoscopic lobectomy (25.5%). The mean operative time was 110.24±38.12 min. The average intraoperative blood loss was 112.35±87.85 mL. The mean postoperative hospital stay was 7.75±3.27 days. Prolonged air leak was found in 6 patients (11.8%), followed by excessive effusion which was found in 4 patients (7.8%). No life-threatening complications or resurgence of fungal infection occurred after surgery. Twenty-seven patients (52.9%) received postoperative antifungal therapies. No 30-day mortality and pulmonary fungal infection recurrence occurred in 6 to 24 months follow-ups.
VATS is an effective and safe option in management of invasive pulmonary fungal infection among patients with haematological diseases.
血液系统疾病患者的侵袭性肺部真菌感染有时是诊断和治疗中的难题。本回顾性研究旨在评估电视辅助胸腔镜手术（VATS）治疗该问题的效果。
2011年1月至2017年12月，共有51例血液系统疾病患者因侵袭性肺部真菌感染接受了VATS手术。我们收集并分析了包括一般情况、血液系统疾病类型、术前临床症状、手术方式、术后住院时间、术后并发症发生率及术后随访等潜在因素。
51例患者中，32例行电视辅助胸腔镜楔形切除术（62.7%），6例行电视辅助胸腔镜肺段切除术（11.8%），13例行电视辅助胸腔镜肺叶切除术（25.5%）。平均手术时间为110.24±38.12分钟。术中平均出血量为112.35±87.85毫升。术后平均住院时间为7.75±3.27天。6例患者（11.8%）出现持续性漏气，4例患者（7.8%）出现胸腔积液过多。术后未发生危及生命的并发症或真菌感染复发。27例患者（52.9%）接受了术后抗真菌治疗。在6至24个月的随访中，未发生30天死亡率和肺部真菌感染复发。
VATS是治疗血液系统疾病患者侵袭性肺部真菌感染的一种有效且安全的选择。
