Clinical comparison of pulmonary lobectomy in patients with massive hemoptysis of pulmonary tuberculosis after bronchial artery embolization_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JIANG Yuhui , SHEN Lei ,  DAI Xiyong , SHENG Jian , LIU Xiaoyu

Department of Surgery, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, 430030, P.R.China;

Corresponding author：

DAI Xiyong, Email: daixiyong71@126.com

Keywords：

Pulmonary tuberculosis; hemoptysis; embolization; pneumonectomy; comparative study

DOI：

10.7507/1007-4848.201906027

Video：

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Objective To compare the clinical data of pulmonary lobectomy in patients with massive hemoptysis of pulmonary tuberculosis after bronchial artery embolization in the short and long term, so as to provide a reference for clinical choices of appropriate operation time.Methods A retrospective analysis was conducted on 33 patients with massive hemoptysis of pulmonary tuberculosis, who had received pulmonary lobectomy after bronchial artery embolization in Wuhan Pulmonary Hospital from January 2015 to November 2017, including 29 males and 4 females aged of 23-66 (52.64±9.70) years. According to the time interval between bronchial artery embolization and lobectomy, the patients were divided into a short-term group (<2 weeks, 14 patients) and a long-term group (>1 month, 19 patients). The clinical data, such as operation time, intraoperative blood loss, postoperative extubation time and serious postoperative complications, were observed in the two groups for statistical analysis.Results The operative time (297.13±75.69 min vs. 231.32±67.57 min, P=0.013), intraoperative blood loss (685.74±325.51 mL vs. 355.83±259.11 mL, P=0.002), postoperative extubation time (14.07±5.24 d vs. 8.90±3.57 d, P=0.003) of the short-term group were all higher than those in the long-term group.Conclusion For the patients with massive hemoptysis of pulmonary tuberculosis, who had surgical indications and no risk of early rebleeding after bronchial artery embolization, pulmonary lobectomy should be performed late until the patient's physical condition and the primary disease was stable.

Citation： JIANG Yuhui, SHEN Lei, DAI Xiyong, SHENG Jian, LIU Xiaoyu. Clinical comparison of pulmonary lobectomy in patients with massive hemoptysis of pulmonary tuberculosis after bronchial artery embolization. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(12): 1190-1193. doi: 10.7507/1007-4848.201906027 Copy

1.	Cordovilla R, Bollo de Miguel E, Nuñez Ares A, et al. Diagnosis and treatment of hemoptysis. arch bronconeumol, 2016, 52(7): 368-77.
2.	Denning DW, Cadranel J, Beigelman-Aubry C, et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J, 2016, 47(1): 45-68.
3.	唐神结, 许绍发, 李亮, 主编. 耐药结核病学. 北京: 人民卫生出版社, 2014. 63-64.
4.	Zhang Y, Chen C, Jiang GN. Surgery of massive hemoptysis in pulmonary tuberculosis: immediate and long-term outcomes. J Thorac Cardiovasc Surg, 2014, 148(2): 651-6.
5.	王兴安, 丁嘉安, 郑华. 大咯血的急诊外科治疗. 中国急救医学, 2004, 24(5): 332-334.
6.	唐文, 拜都如拉·艾尼吐, 付毅, 等. 肺结核大咯血 27 例急诊外科治疗分析. 临床外科杂志, 2016, (9): 725-725.
7.	Miyano Y, Kanzaki M, Onuki T. Bronchial artery embolization: first-line option for managing massive hemoptysis. Asian Cardiovasc Thorac Ann, 2017, 25(9): 618-622.
8.	Yendamuri S. Massive airway hemorrhage. Thorac Surg Clin, 2015, 25(3): 255-60.
9.	黄明声, 单鸿. 超选择性支气管动脉栓塞治疗肺结核大咯血的价值. 介入放射学杂志, 2000, 9(2): 79-81.
10.	张守民, 李景英, 王国兴. 支气管动脉栓塞治疗肺结核咯血的疗效及复发原因分析. 介入放射学杂志, 2012, 21(5): 414-417.
11.	Xu W, Wang HH, Bai B. Emergency transcatheter arterial embolization for massive hemoptysis due to pulmonary tuberculosis and tuberculosis sequelae. Cell Biochem Biophys, 2015, 71(1): 179-87.
12.	李晶晶, 李瑛, 胡成平, 等. 支气管扩张症和肺结核咯血患者介入治疗效果比较. 中华结核和呼吸杂志, 2012, 35(6): 447-449.
13.	Halezeroğlu S, Okur E. Thoracic surgery for haemoptysis in the context of tuberculosis: what is the best management approach? J Thorac Dis, 2014, 6(3): 182-185.
14.	Chen G, Zhong FM, Xu XD, et al. Efficacy of regional arterial embolization before pleuropulmonary resection in 32 patients with tuberculosis-destroyed lung. BMC Pulm Med, 2018, 18(1): 156.
15.	Gross AM, Diacon AH, van den Heuvel MM, et al. Management of life-threatening haemoptysis in an area of high tuberculosis incidence. Int J Tuberc Lung Dis, 2009, 13(7): 875-880.
16.	朱建坤, 刘大伟, 金锋, 等. 顽固性咯血患者肺叶切除术前行动脉栓塞介入治疗的价值. 中国防痨杂志, 2018, 40(12): 1258-1261.

1. Cordovilla R, Bollo de Miguel E, Nuñez Ares A, et al. Diagnosis and treatment of hemoptysis. arch bronconeumol, 2016, 52(7): 368-77.
2. Denning DW, Cadranel J, Beigelman-Aubry C, et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J, 2016, 47(1): 45-68.
3. 唐神结, 许绍发, 李亮, 主编. 耐药结核病学. 北京: 人民卫生出版社, 2014. 63-64.
4. Zhang Y, Chen C, Jiang GN. Surgery of massive hemoptysis in pulmonary tuberculosis: immediate and long-term outcomes. J Thorac Cardiovasc Surg, 2014, 148(2): 651-6.
5. 王兴安, 丁嘉安, 郑华. 大咯血的急诊外科治疗. 中国急救医学, 2004, 24(5): 332-334.
6. 唐文, 拜都如拉·艾尼吐, 付毅, 等. 肺结核大咯血 27 例急诊外科治疗分析. 临床外科杂志, 2016, (9): 725-725.
7. Miyano Y, Kanzaki M, Onuki T. Bronchial artery embolization: first-line option for managing massive hemoptysis. Asian Cardiovasc Thorac Ann, 2017, 25(9): 618-622.
8. Yendamuri S. Massive airway hemorrhage. Thorac Surg Clin, 2015, 25(3): 255-60.
9. 黄明声, 单鸿. 超选择性支气管动脉栓塞治疗肺结核大咯血的价值. 介入放射学杂志, 2000, 9(2): 79-81.
10. 张守民, 李景英, 王国兴. 支气管动脉栓塞治疗肺结核咯血的疗效及复发原因分析. 介入放射学杂志, 2012, 21(5): 414-417.
11. Xu W, Wang HH, Bai B. Emergency transcatheter arterial embolization for massive hemoptysis due to pulmonary tuberculosis and tuberculosis sequelae. Cell Biochem Biophys, 2015, 71(1): 179-87.
12. 李晶晶, 李瑛, 胡成平, 等. 支气管扩张症和肺结核咯血患者介入治疗效果比较. 中华结核和呼吸杂志, 2012, 35(6): 447-449.
13. Halezeroğlu S, Okur E. Thoracic surgery for haemoptysis in the context of tuberculosis: what is the best management approach? J Thorac Dis, 2014, 6(3): 182-185.
14. Chen G, Zhong FM, Xu XD, et al. Efficacy of regional arterial embolization before pleuropulmonary resection in 32 patients with tuberculosis-destroyed lung. BMC Pulm Med, 2018, 18(1): 156.
15. Gross AM, Diacon AH, van den Heuvel MM, et al. Management of life-threatening haemoptysis in an area of high tuberculosis incidence. Int J Tuberc Lung Dis, 2009, 13(7): 875-880.
16. 朱建坤, 刘大伟, 金锋, 等. 顽固性咯血患者肺叶切除术前行动脉栓塞介入治疗的价值. 中国防痨杂志, 2018, 40(12): 1258-1261.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical comparison of pulmonary lobectomy in patients with massive hemoptysis of pulmonary tuberculosis after bronchial artery embolization

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