Leow Lowell, Anbudurai Manisha, Yue Li, Tam John Kit Chung
Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, Singapore, Singapore.
Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
J Med Case Rep. 2023 Oct 7;17(1):420. doi: 10.1186/s13256-023-04162-y.
Pembrolizumab as immunotherapy is increasingly used in adjuvant, neoadjuvant, and standalone therapy and has been described as safe. We share an experience of lung erosion post-thoracic surgery with the use of adjuvant pembrolizumab.
A 65-year-old Chinese gentleman with metastatic renal cell carcinoma underwent lung metastasis resection and presented with delayed onset pneumothorax while on adjuvant pembrolizumab. Failure of conservative management warranted repeat surgical intervention, and intraoperative findings showed erosion of staple lines possibly caused by poor healing associated with pembrolizumab.
Adjuvant pembrolizumab may impair wound healing, including stapler line healing. Presentation of delayed pneumothorax in a post-surgical patient undergoing immunotherapy should warrant early surgical intervention.
帕博利珠单抗作为免疫疗法越来越多地用于辅助、新辅助和单独治疗，且已被描述为安全的。我们分享一例在辅助使用帕博利珠单抗的情况下胸外科手术后出现肺侵蚀的经验。
一名65岁患有转移性肾细胞癌的中国男性接受了肺转移瘤切除术，在接受辅助帕博利珠单抗治疗时出现延迟性气胸。保守治疗失败后需要再次进行手术干预，术中发现吻合钉线侵蚀，可能是由与帕博利珠单抗相关的愈合不良所致。
辅助使用帕博利珠单抗可能会损害伤口愈合，包括吻合钉线的愈合。接受免疫治疗的术后患者出现延迟性气胸应尽早进行手术干预。
