Kushwaha Naveen Kumar, Jaiswal Pradeep, Singh Vijay Pratap, Harish S, Gupta Prashant
Department of Surgical Oncology, Army Hospital (Research & Referral), New Delhi, India 110010.
Department of Surgical Oncology, Command Hospital Kolkata, Kolkata, India.
Indian J Surg Oncol. 2025 Feb;16(1):364-375. doi: 10.1007/s13193-024-02101-x. Epub 2024 Sep 24.
Pathologic conditions affecting the central airways encompass a wide array of focal alterations. The diagnosis of central airway lesions poses considerable challenges due to their varied presentations, resulting in delayed recognition and management. However, advances in bronchoscopy and multidetector computed tomography (MDCT) aid in early detection. Management depends both on the pathology and the obstructive potential of the process. We present our experience with the comprehensive evaluation and management of 11 cases of focal tracheobronchial lesions surgically treated at our institution, with an emphasis on lung parenchyma preservation. This is a retrospective analysis of prospectively maintained data of 11 patients who were surgically treated for focal tracheobronchial lesions between January 2021 and December 2023 at a tertiary care hospital in India. Their demographic data, clinical presentation, and perioperative details were recorded. All patients underwent MDCT chest, bronchoscopy, and pulmonary function tests as part of the workup for diagnosis and assessment. The study included nine male and two female patients with a mean age of 36.4 years (range 9-64 years). Surgical procedures included main bronchus sleeve resection (3 patients), sleeve lobectomies (3 patients), sleeve bi-lobectomy (1 patient), and tracheal resection with end-to-end anastomosis (4 patients). Postoperatively, one patient died due to acute respiratory distress syndrome (ARDS). Pathological evaluation revealed malignant causes in 9 patients and non-neoplastic causes in 2 patients. The mean hospital stay was 6.5 days, with chest tube removal at 5.6 days. The average follow-up period was 8.2 months, ranging from 6 to 15 months. Based on our series, we ascertain that a complete resection, whenever feasible, offers optimal potential benefits and symptom alleviation for individuals with focal tracheobronchial lesions. Enhanced recognition of these lesions, coupled with a heightened level of suspicion and prompt diagnosis, stands pivotal in ensuring the safe and efficacious management of such cases.
影响中央气道的病理状况包括一系列广泛的局灶性改变。中央气道病变的诊断因其表现多样而极具挑战，导致识别和处理延迟。然而，支气管镜检查和多排螺旋计算机断层扫描（MDCT）的进展有助于早期发现。治疗方案取决于病变的病理类型及其阻塞潜力。我们介绍了在我们机构接受手术治疗的11例局灶性气管支气管病变的综合评估和治疗经验，重点是肺实质的保留。这是一项对2021年1月至2023年12月在印度一家三级医院接受手术治疗的11例局灶性气管支气管病变患者的前瞻性维护数据进行的回顾性分析。记录了他们的人口统计学数据、临床表现和围手术期细节。作为诊断和评估检查的一部分，所有患者均接受了胸部MDCT、支气管镜检查和肺功能测试。该研究包括9名男性和2名女性患者，平均年龄为36.4岁（范围9 - 64岁）。手术方式包括主支气管袖状切除术（3例）、袖状肺叶切除术（3例）、袖状双肺叶切除术（1例）和气管端端吻合术（4例）。术后，1例患者因急性呼吸窘迫综合征（ARDS）死亡。病理评估显示9例为恶性病因，2例为非肿瘤性病因。平均住院时间为6.5天，胸腔引流管在5.6天拔除。平均随访期为8.2个月，范围为6至15个月。基于我们的系列研究，我们确定只要可行，完整切除可为局灶性气管支气管病变患者带来最佳潜在益处并缓解症状。加强对这些病变的认识，提高怀疑程度并及时诊断，对于确保此类病例的安全有效管理至关重要。
