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[肺结节和肺癌患者新型冠状病毒感染后肺手术时机的初步建议]

[Preliminary Recommendations on the Timing of Lung Surgery after 
Novel Coronavirus Infection in Patients with Pulmonary Nodules and Lung Cancer].

作者信息

Li Xin, Dong Ming, Xu Song, Zhao Honglin, Wei Sen, Song Zuoqing, Liu Minghui, Ren Dian, Ren Fan, Zhao Qingchun, Liu Renwang, Xia Chunqiu, Chen Gang, Chen Jun

机构信息

Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2023 Feb 20;26(2):148-150. doi: 10.3779/j.issn.1009-3419.2023.102.04. Epub 2023 Jan 30.

Abstract

In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contracting COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery.
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摘要

近年来,2019冠状病毒病(COVID-19)大流行对全球医学、政治和经济领域产生了巨大影响。自COVID-19疫情开始以来,我们对COVID-19影响的认识呈指数级增长。最近,COVID-19疫情在中国迅速变化,对于如何为肺部肿瘤性病变患者开展外科手术存在争议。一些研究表明,与普通人群相比,接受手术的肺癌患者感染COVID-19后更易出现呼吸衰竭和围手术期死亡,然而,癌症治疗的延迟也与这些患者的死亡率增加有关。特别是,新型冠状病毒奥密克戎变异株具有更高的传播性,可能会逃避通过先前的新型冠状病毒感染和疫苗接种获得的免疫力。为了将外科手术患者感染新型冠状病毒的风险降至最低,有必要制定新的治疗指南、专家共识和预防措施。然而,当前疫情形势的快速变化导致制定指南和共识的时间和证据不足。因此,胸外科医生在手术前需要评估严重并发症风险较高的特定患者群体,并权衡手术治疗的益处与新型冠状病毒感染的风险。我们试图根据不同地区肿瘤学和胸外科组织关于肺部手术的指南和共识,就当前国内疫情期间的肺部手术给出一些建议。

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