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在长期病程中，硅橡胶是治疗肺切除术后综合征的一种有效扩张材料：病例报告

SF is a useful expander for post-pneumonectomy syndrome in the long-term course: a case report.

作者信息

Maeda Koki, Imamura Nobuhiro, Tabata Keisuke, Morizono Shoichiro, Tokunaga Takuya, Takeda Aya, Kamimura Go, Masashi Oniwa, Mizuno Keiko, Aoki Masaya, Ueda Kazuhiro

机构信息

Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.

Department of Respiratory Medicine, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.

出版信息

Surg Case Rep. 2024 Jul 17;10(1):172. doi: 10.1186/s40792-024-01972-0.

DOI:10.1186/s40792-024-01972-0
PMID:39017809
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11254868/
Abstract

BACKGROUND

Post-pneumonectomy syndrome (PPS) is a rare but serious condition that can occur after pneumonectomy. It is characterized by a mediastinal shift towards the vacated hemithorax, which can potentially lead to respiratory failure. The management of PPS poses a clinical challenge, especially in the context of the limited availability of certain therapeutic devices due to regulatory restrictions in Japan.

CASE PRESENTATION

A 36-year-old female with stage IB non-small cell lung cancer underwent left pneumonectomy. Approximately 2 years later, she developed dyspnea. After consulting with our hospital, subsequent imaging revealed an extreme mediastinal shift causing bronchial obstruction. Emergency thoracotomy and subsequent sulfur hexafluoride (SF) injections were successfully used to manage her condition. Over the course of follow-up, the interval between SF injections was extended from 3 to 11 months, indicating an improvement in the intrathoracic condition.

CONCLUSIONS

This case illustrates the efficacy of SF gas in treating PPS and in reducing the frequency of medical interventions. SF gas administration is safe and effective for the treatment of patients with PPS.

摘要

背景

肺切除术后综合征（PPS）是一种罕见但严重的疾病，可发生于肺切除术后。其特征为纵隔向患侧胸腔移位，这可能会导致呼吸衰竭。PPS的治疗是一项临床挑战，尤其是在日本由于监管限制某些治疗设备供应有限的情况下。

病例报告

一名36岁患有ⅠB期非小细胞肺癌的女性接受了左肺切除术。大约2年后，她出现呼吸困难。在与我院会诊后，后续影像学检查显示纵隔极度移位导致支气管阻塞。紧急开胸手术及随后的六氟化硫（SF）注射成功用于治疗她的病情。在随访过程中，SF注射的间隔时间从3个月延长至11个月，表明胸腔内状况有所改善。

结论

本病例说明了SF气体在治疗PPS及减少医疗干预频率方面的有效性。SF气体给药对PPS患者的治疗是安全有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/efc6b2b8fcb4/40792_2024_1972_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/ced52cd010b3/40792_2024_1972_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/f26c73977f6c/40792_2024_1972_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/317ff9621d4c/40792_2024_1972_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/43a9f27902ca/40792_2024_1972_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/4e48e4549d96/40792_2024_1972_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/efc6b2b8fcb4/40792_2024_1972_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/ced52cd010b3/40792_2024_1972_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/f26c73977f6c/40792_2024_1972_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/317ff9621d4c/40792_2024_1972_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/43a9f27902ca/40792_2024_1972_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/4e48e4549d96/40792_2024_1972_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e759/11254868/efc6b2b8fcb4/40792_2024_1972_Fig6_HTML.jpg

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本文引用的文献

1
Post-pneumonectomy syndrome: a systematic review of the current evidence and treatment options.肺切除术后综合征：当前证据和治疗选择的系统评价。
J Cardiothorac Surg. 2023 Apr 10;18(1):119. doi: 10.1186/s13019-023-02278-2.
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Lung Cancer in Japan.日本的肺癌
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Surgical correction of postpneumonectomy syndrome with adjustable saline implants and transoesophageal echocardiography.采用可调节盐水植入物及经食管超声心动图对肺切除术后综合征进行手术矫正。
Eur J Cardiothorac Surg. 2020 Jun 1;57(6):1224-1226. doi: 10.1093/ejcts/ezz311.
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Correction of postpneumonectomy syndrome with tridimensional carbon fiber-printed implant.三维碳纤维打印植入物矫正肺切除术后综合征
J Thorac Cardiovasc Surg. 2018 Apr;155(4):e135-e137. doi: 10.1016/j.jtcvs.2017.11.081. Epub 2017 Dec 13.
5
Surgical Treatment of Postpneumonectomy Syndrome with Tissue Expanders in Children.儿童肺切除术后综合征的组织扩张器手术治疗
Korean J Thorac Cardiovasc Surg. 2015 Jun;48(3):217-9. doi: 10.5090/kjtcs.2015.48.3.217. Epub 2015 Jun 5.
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Left postpneumonectomy syndrome successfully treated with endobronchial stent.经支气管内支架成功治疗左肺切除术后综合征
Intern Med. 1998 Oct;37(10):880-3. doi: 10.2169/internalmedicine.37.880.
8
Management of postpneumonectomy syndrome by intrapleural injection of sulfur hexafluoride. Case report.通过胸膜腔内注射六氟化硫治疗肺切除术后综合征。病例报告。
Scand J Thorac Cardiovasc Surg. 1993;27(3-4):179-81. doi: 10.3109/14017439309099108.
9
Use of sulfur hexafluoride, SF6, in the management of the postpneumonectomy pleural space.六氟化硫（SF6）在肺切除术后胸膜腔处理中的应用。
Respiration. 1984;46(2):201-8. doi: 10.1159/000194690.