|
|
|
| Clinical effect of thoracoscopic surgery for patients with pulmonary aspergilloma and the influence on the postoperative stress reaction |
| CAI Renzhong CHEN Xianshan CHEN Fengxia |
| Department of Thoracic Surgery, People′s Hospital of Hainan Province, Hainan Province, Haikou 570103, China |
|
|
|
Abstract Objective To discuss the possibility and safety of video-assisted thoracoscope surgery (VATS) for pulmonary aspergilloma and the postoperative stress reaction. Methods The clinical data of 66 patients with pulmonary aspergilloma in People′s Hospital of Hainan Province from February 2011 to September 2016 were retrospectively analyzed. The patients were divided into two groups according to their operation method including a conventional thoracotomy surgery group (open group, n = 36) and a video-assisted thoracoscope pneumonectomy group (VATS group, n = 30). The clinical data, complications, NPS and stress reaction-related indicators of the two groups were observed after surgery. Results The operations of all patients were performed successfully. The VATS group was significantly lower than the open group in the operation time, bleeding, total postoperative drainage, the 7th day pain score and the 30th day pain score (P < 0.05). There were no statistical differences in the time of hospitalization, the 1st day pain score and postoperation complication (P > 0.05). In stress response indexes (cortisol, prostaglandin E2 and P substance), the postoperative levels of 1st day and 7th day in the VATS group were significantly lower than those in the open group (P < 0.05). In inflammatory reaction indexes (C-reactive protein, interleukin 6 and tumor necrosis factor-α), the postoperative levels of 1st day and 7th day in the VATS group were significantly lower than those in the open group (P < 0.05). Conclusion VATS for pulmonary aspergilloma, if applicable, may be reliable therapeutic effect, and less impact on the postoperative stress reaction. It is worthy of clinical application.
|
|
|
|
|
|
[1] Pennington JE. Aspergillus lung disease [J]. Med Clin North Am，1980，64（3）：475-490.
[2] El HM，Traibi A，El OF，et al. Surgical treatment of aspergilloma grafted in hydatid cyst cavity [J]. Rev Port Pneumol，2013，19（6）：281-283.
[3] Ba PS，Ndiaye A，Diatta S，et al. Results of surgical treatment for pulmonary aspergilloma [J]. Med Sante Trop，2015，25（1）：92-96.
[4] 严广斌.NRS疼痛数字评价量表numerical rating scale[J].中华关节外科杂志：电子版，2014，8（3）：410.
[5] Kumar A，Asaf BB，Puri HV，et al. Video-assisted thoracoscopic surgery for pulmonary aspergilloma [J]. Lung India，2017，34（4）：318-323.
[6] Pagès PB，Grima R，Mordant P，et al. Does antifungal therapy influence postoperative morbidity or long-term survival after surgical resection for pulmonary aspergilloma? [J]. Rev Pneumol Clin，2014，70（6）：322-328.
[7] Stather DR，Tremblay A，Dumoulin E，et al. A Series of Transbronchial Removal of Intracavitary Pulmonary Aspergilloma [J]. Ann Thorac Surg，2017，103（3）：945-950.
[8] 杜江，张林.58例肺曲霉菌病患者的临床特点及预后影响因素分析[J].山东医药，2015，55（10）：45-47.
[9] Jewkes J，Kay PH，Paneth M，et al. Pulmonary aspergilloma： analysis of prognosis in relation to haemoptysis and survey of treatment [J]. Thorax，1983，38（8）：572-578.
[10] Afolayan O，Copeland H，Zaheer S，et al. Pulmonary Mucormycosis Treated With Lobectomy [J]. Ann Thorac Surg，2017，103（6）：e531-e533.
[11] Kasprzyk M，Pieczyński K，Mania K，et al. Surgical treatment for pulmonary aspergilloma - early and long-term results [J]. Kardiochir Torakochirurgia Pol，2017，14（2）：99-103.
[12] Rivera C，Arame A，Pricopi C，et al. Pneumonectomy for benign disease： indications and postoperative outcomes，a nationwide study [J]. Eur J Cardiothorac Surg，2015，48（3）：435-440，440.
[13] Li Y，Wang J. Comparison of clinical outcomes for patients with clinical N0 and pathologic N2 non-small cell lung cancer after thoracoscopic lobectomy and open lobectomy： a retrospective analysis of 76 patients [J]. J Surg Oncol，2012，106（4）：431-435.
[14] Mohapatra B，Sivakumar P，Bhattacharya S，et al. Surgical treatment of pulmonary aspergillosis： A single center experience [J]. Lung India，2016，33（1）：9-13.
[15] Chen QK，Chen C，Chen XF，et al. Video-assisted thoracic surgery for pulmonary aspergilloma： a safe and effective procedure [J]. Ann Thorac Surg，2014，97（1）：218-223.
[16] Nagahiro I，Andou A，Aoe M，et al. Pulmonary function，postoperative pain，and serum cytokine level after lobectomy： a comparison of VATS and conventional procedure [J]. Ann Thorac Surg，2001，72（2）：362-365.
[17] Ichinose J，Kohno T，Fujimori S. Video-assisted thoracic surgery for pulmonary aspergilloma [J]. Interact Cardiovasc Thorac Surg，2010，10（6）：927-930.
[18] Walker WS，Leaver HA. Immunologic and stress responses following video-assisted thoracic surgery and open pulmonary lobectomy in early stage lung cancer [J]. Thorac Surg Clin，2007，17（2）：241-249.
[19] Jensen K，Ringsted C，Hansen HJ，et al. Simulation-based training for thoracoscopic lobectomy：a randomized controlled trial： virtual-reality versus black-box simulation [J]. Surg Endosc，2014，28（6）：1821-1829.
[20] 傅毅立，李辉，胡滨，等.全胸腔镜肺切除术治疗肺曲霉菌球的病例对照研究[J].中国胸心血管外科临床杂志，2015，22（6）：564-568.
[21] El HMM，Slaoui O，El OF，et al. Lung resection in pulmonary aspergilloma： experience of a Moroccan center [J]. BMC Surg，2015，15：114. |
|
|
|
