Giang Nguyen Truong, Dung Le Tien, Hien Nguyen Thanh, Thiet Truong Thanh, Hiep Phan Sy, Vu Nguyen The, Pho Dinh Cong, Van Nam Nguyen, Hung Pham Ngoc
Department of Cardiothoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam.
Department of Thoracic Surgery, Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam.
BMC Surg. 2019 Dec 5;19(1):187. doi: 10.1186/s12893-019-0650-1.
In high-risk patients with complex pulmonary aspergilloma but unable for lung resection, cavernostomy and thoracoplasty could be performed. This study aimed to evaluate this surgery compared two compressing materials.
A total of 63 in high-risk patients who suffered from hemoptysis due to complex pulmonary aspergilloma and underwent cavernostomy and thoracoplasty surgery from November 2011 to September 2018 at Pham Ngoc Thach hospital were evaluated prospectively studied. Patients were allocated to two groups: the table tennis ball group and tissue expander group. We evaluated at the time of before operation, 6 months and 24 months after operation.
Tuberculosis was the most common comorbidity diseases in both groups. Upper lobe occupied almost in location. Hemoptysis symptoms plunged from time to time. Statistically significant Karnofsky score was observed in both groups. Postoperative pulmonary functions (FVC and FEV1) have remained in both groups at all time points. The remarkable results were no deaths related to surgery and low complications both short and long-term. There was no statistical significance between two groups in operative time, blood loss during operation, ICU length-stay time. Four patients died because of co-morbidity in 24 months follow-up.
Cavernostomy and thoracoplasty was safe and effective surgery for the treatment of complex pulmonary aspergilloma with hemoptysis in high-risk patients. No mortality related to surgery and low complications were recorded. The was no inferiority when compared two compressing materials .
对于患有复杂肺曲菌球但无法进行肺切除术的高危患者,可进行空洞造口术和胸廓成形术。本研究旨在评估这种手术并比较两种填充材料。
对2011年11月至2018年9月在范老五医院因复杂肺曲菌球咯血而接受空洞造口术和胸廓成形术的63例高危患者进行前瞻性研究。患者被分为两组:乒乓球组和组织扩张器组。我们在术前、术后6个月和24个月时进行评估。
两组中最常见的合并症都是肺结核。病变部位几乎都在上叶。咯血症状时有下降。两组的卡诺夫斯基评分有统计学意义。两组在所有时间点的术后肺功能(FVC和FEV1)均保持稳定。显著的结果是无手术相关死亡,短期和长期并发症均较少。两组在手术时间、术中失血、ICU住院时间方面无统计学意义。在24个月的随访中,有4例患者因合并症死亡。
空洞造口术和胸廓成形术是治疗高危患者复杂肺曲菌球伴咯血的安全有效的手术。未记录到手术相关死亡,并发症较少。比较两种填充材料时无劣势。