这是一名 39 岁女性的案例,她有漏斗胸病史。 在因疑似肺部感染完成整个疗程的抗生素治疗后,她出现了无法解决的左侧胸膜炎疼痛、干咳、发烧和轻度呼吸急促。 体格检查未发现异常发现。 化验结果和胸部 X 光检查无异常。 胸部 CT 增强扫描显示存在与左下叶外侧和后段相连的远端胸主动脉异常动脉分支,提示叶内肺隔离症。 决定通过电视辅助胸腔镜手术进行下肺叶切除术。 手术顺利,患者在术后第 8 天出院。病理结果显示存在肺叶内肺隔离症,伴有支气管扩张、纤维化和慢性炎症浸润。
参考:
1. Nomori H, Shiraishi A, Cong Y, Sugimura H, Mishima S. Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy. Eur J Cardiothorac Surg 2018 1;53(3):640.
2. Butler JP, Loring SH, Patz S, et al. Evidence for adult lung growth in humans. N Engl J Med 2012; 367: 244–247.
3. Mizobuchi T, Wada H, Sakairi Y, et al. Spirometric and radiological evaluation of the remnant lung long after major pulmonary resection: can compensatory phenomena be recognized in clinical cases? Surg Today 2014; 44: 1735–1743.
4. Wang X, Guo H, Hu Q, Ying Y, Chen B. Pulmonary function after segmentectomy versus lobectomy in patients with early-stage non-small-cell lung cancer: a meta-analysis. Journal of International Medical Research. September 2021. doi:10.1177/03000605211044204.
5. Charloux A, Quoix E. Lung segmentectomy: does it offer a real functional benefit over lobectomy? Eur Respir Rev. 2017 Oct 25;26(146):170079. doi: 10.1183/16000617.0079-2017. PMID: 29070582.
6. Bédat B, Abdelnour-Berchtold E, Krueger T, et al. Impact of complex segmentectomies by video-assisted thoracic surgery on peri-operative outcomes. J Thorac Dis. 2019;11(10):4109-4118. doi:10.21037/jtd.2019.10.07.
7. Suzuki K, Saji H, Aokage K, Watanabe SI, Okada M, Mizusawa J, Nakajima R, Tsuboi M, Nakamura S, Nakamura K, Mitsudomi T, Asamura H; West Japan Oncology Group; Japan Clinical Oncology Group. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg. 2019 Sep;158(3):895-907. doi: 10.1016/j.jtcvs.2019.03.090. Epub 2019 Apr 9. PMID: 31078312.
8. Saji, Hisashi and Okada, Morihito and Tsuboi, Masahiro and Nakajima, Ryu and Suzuki, Kenji and Aokage, Keiju and Aoki, Tadashi and Okami, Jiro and Yoshino, Ichiro and Ito, Hiroyuki and Okumura, Norihito and Yamaguchi, Masafumi and Ikeda, Norihiko and Wakabayashi, Masashi and Nakamura, Kenichi and Fukuda, Haruhiko and Nakamura, Shinichiro and Mitsudomi, Tetsuya and Watanabe, Shun-ichi and Asamura, Hisao and Group, West Japan Oncology and Group, Japan Clinical Oncology, Segmentectomy Versus Lobectomy in Small-Sized Peripheral Non-Small Cell Lung Cancer (JCOG0802/WJOG4607L): A Multicentre, Randomised, Controlled, Phase 3 Trial.
9. Wentao Fang, Commentary: Is segmentectomy ready to be accepted as the standard of care?, The Journal of Thoracic and Cardiovascular Surgery, Volume 161, Issue 1, 2021, Pages 292-293, ISSN 0022-5223, https://doi.org/10.1016/j.jtcvs.2020.01.037. |