左肺上叶切除术后的胸部放疗可能是肺静脉残端血栓形成的一个危险因素。

Chest radiotherapy after left upper lobectomy may be a risk factor for thrombosis in the pulmonary vein stump.

机构信息

Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.

Department of Thoracic Surgery, Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, China.

出版信息

J Cardiothorac Surg. 2022 Jun 13;17(1):154. doi: 10.1186/s13019-022-01902-x.

DOI:10.1186/s13019-022-01902-x

PMID:35698075

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9195320/

Abstract

BACKGROUND

Thrombosis in the pulmonary vein stump (PVS) is not a well-known complication after pulmonary lobectomy, but it has the potential to cause embolism to vital organs. The aim of this study was to evaluate the risk factors for thrombosis in the PVS after pulmonary lobectomy.

METHODS

A total of 439 patients who underwent pulmonary lobectomy from 2008 to 2017 were retrospectively reviewed, and 412 patients were further analyzed. The state of the PVS was evaluated by chest contrast-enhanced computed tomography (CECT). Univariate analysis was performed to evaluate the potential risk factors for thrombosis in the PVS.

RESULTS

Thrombosis in the PVS was detected in 6 of 412 (1.5%) patients, and 5 of them underwent left upper lobectomy (LUL) (5/100, 5.0%) (P = 0.004). In the analyses of the LUL group, postoperative chest radiotherapy was identified as a risk factor for thrombosis in the PVS (P = 0.024), and postoperative atrial fibrillation showed a tendency to be a risk factor for thrombosis (P = 0.058).

CONCLUSIONS

Chest radiotherapy after LUL is a possible risk factor for thrombosis in the PVS. Periodic chest CECT is recommended after postoperative chest radiotherapy for patients after LUL.

摘要

背景

肺静脉残端（PVS）血栓形成并不是肺叶切除术后的一种常见并发症，但它有可能导致重要器官栓塞。本研究旨在评估肺叶切除术后 PVS 血栓形成的危险因素。

方法

回顾性分析了 2008 年至 2017 年间接受肺叶切除术的 439 例患者，其中 412 例进一步进行了分析。通过胸部增强计算机断层扫描（CECT）评估 PVS 的状态。采用单因素分析评估 PVS 血栓形成的潜在危险因素。

结果

在 412 例患者中，有 6 例（1.5%）检测到 PVS 血栓形成，其中 5 例接受了左上肺叶切除术（LUL）（5/100，5.0%）（P=0.004）。在 LUL 组的分析中，术后胸部放疗被确定为 PVS 血栓形成的危险因素（P=0.024），术后心房颤动也显示出成为血栓形成危险因素的趋势（P=0.058）。