Kamigaichi Atsushi, Tsutani Yasuhiro, Handa Yoshinori, Mimae Takahiro, Miyata Yoshihiro, Okada Morihito
Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Surg Today. 2023 Mar;53(3):379-385. doi: 10.1007/s00595-022-02604-6. Epub 2022 Oct 19.
This study aimed to elucidate the feasibility of repeated ipsilateral anatomical pulmonary resection.
The subjects of this retrospective analysis were 50 patients who underwent ipsilateral anatomical pulmonary resection after major lung surgery. The patients were divided into two groups according to the type of primary operation performed: a repeated anatomical pulmonary resection group (RA group; n = 24) and an anatomical pulmonary resection after wedge resection group (AW group; n = 26). We compared the perioperative outcomes of the two groups.
Completion lobectomy was performed in 9 of the 24 patients (38%) from the RA group and adhesion of the pulmonary hilum was more severe in this group (P = 0.004). Although the operative time was significantly longer in the RA group (P = 0.030), there was no significant difference in the amount of blood loss (P = 0.217) between the groups. A significantly higher rate of severe postoperative complications was observed in the RA group (42%) than in the AW group (12%) (P = 0.024). None of the patients who underwent repeated surgery died within 90 days postoperatively.
Although repeated anatomical pulmonary resection is a more challenging procedure than anatomical resection after wedge resection, it does not increase short-term mortality; therefore, it is a feasible treatment option.
本研究旨在阐明同侧重复进行解剖性肺切除术的可行性。
本回顾性分析的对象为50例在进行大型肺部手术后接受同侧解剖性肺切除术的患者。根据初次手术类型将患者分为两组：重复解剖性肺切除组（RA组；n = 24）和楔形切除术后解剖性肺切除组（AW组；n = 26）。我们比较了两组的围手术期结果。
RA组24例患者中有9例（38%）完成了肺叶切除术，且该组肺门粘连更严重（P = 0.004）。虽然RA组的手术时间明显更长（P = 0.030），但两组间失血量无显著差异（P = 0.217）。RA组术后严重并发症发生率（42%）显著高于AW组（12%）（P = 0.024）。接受重复手术的患者术后90天内均无死亡。
虽然同侧重复进行解剖性肺切除术比楔形切除术后解剖性切除术更具挑战性，但它不会增加短期死亡率；因此，它是一种可行的治疗选择。
