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肺曲菌球解剖性肺切除术后影响生存的因素:我们单机构的10年经验。

Factors affecting survival after anatomical lung resection in pulmonary aspergilloma: Our 10-year single institution experience.

作者信息

Sezen Celal Buğra, Aker Cemal, Doğru Mustafa Vedat, Aksoy Yunus, Bilen Salih, Sönmezoğlu Yaşar, Erdoğu Volkan, Cansever Levent, Metin Muzaffer

机构信息

Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2022 Jan 28;30(1):92-100. doi: 10.5606/tgkdc.dergisi.2022.19982. eCollection 2022 Jan.

Abstract

BACKGROUND

The aim of this study was to investigate the long-term outcomes of patients who underwent anatomic lung resection for pulmonary aspergilloma and to evaluate the prognostic factors affecting early postoperative morbidity.

METHODS

Between January 2007 and January 2017, we retrospectively evaluated a total of 55 patients (40 males, 15 females; mean age: 44.6 years; range, 18 to 75 years) who underwent lobectomy and pneumonectomy for pulmonary aspergilloma. All patients were evaluated for simple or complex aspergilloma based on imaging and thoracotomy findings.

RESULTS

Thirty-two (58.2%) patients presented with hemoptysis. Seven (12.7%) patients underwent emergency surgery due to massive hemoptysis. Postoperative morbidity was observed in 15 (27.3%) patients. Prognostic factors that had an effect on morbidity were resection type, Charlson Comorbidity Index >3, and massive hemoptysis (p<0.05). There was no intra- or postoperative mortality. The five-year survival rate was 89.4%. None of the factors evaluated in the study were associated with survival.

CONCLUSION

The main finding of this study is the absence of mortality after surgical treatment for pulmonary aspergilloma. The success of surgical treatment depends on the management of postoperative complications.

摘要

背景

本研究的目的是调查接受肺曲菌球解剖性肺切除术患者的长期预后,并评估影响术后早期发病率的预后因素。

方法

2007年1月至2017年1月期间,我们回顾性评估了55例因肺曲菌球接受肺叶切除术和全肺切除术的患者(40例男性,15例女性;平均年龄:44.6岁;范围18至75岁)。根据影像学和开胸手术结果对所有患者的曲菌球进行简单或复杂评估。

结果

32例(58.2%)患者出现咯血。7例(12.7%)患者因大量咯血接受急诊手术。15例(27.3%)患者出现术后并发症。影响并发症的预后因素为手术切除类型、查尔森合并症指数>3和大量咯血(p<0.05)。无术中或术后死亡。五年生存率为89.4%。本研究评估的因素均与生存率无关。

结论

本研究的主要发现是肺曲菌球手术治疗后无死亡病例。手术治疗的成功取决于术后并发症的处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbb8/8990155/c46ac6bb5ae4/TJTCS-2022-30-1-092-100-F1.jpg

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