Application of single-direction lobectomy in the treatment of complicated pulmonary tuberculosis: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JIANG Yuhui , SHEN Lei ,  DAI Xiyong

Department of Surgery, Wuhan Pulmonary Hospital, Wuhan, 430030, P. R. China;

Corresponding author：

DAI Xiyong, Email: daixiyong71@126.com

Keywords：

Pulmonary tuberculosis; single-direction; lobectomy; cohort study

DOI：

10.7507/1007-4848.202012082

Video：

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Objective To explore the value of the single-direction lobectomy in the treatment of complicated pulmonary tuberculosis.Methods A retrospective analysis was performed on 88 patients with complicated pulmonary tuberculosis who received lobectomy in our hospital from 2017 to 2019. There were 64 males and 24 females, with an average age of 21-70 (47.67±13.39) years. According to the surgical procedure, patients who received single-direction lobectomy were divided into a single-direction group (n=32), and those who received traditional lobectomy were divided into a control group (n=56).Results The two groups had no statistical differences in gender, age, primary disease and complications, lesion morphology, clinical symptoms, operative site, interlobitis adhesion or hilar mediastinal lymph node calcification (P>0.05). Operation time [210.0 (180.0, 315.0) min vs. 300.0 (240.0, 320.0) min], intraoperative blood loss [200.0 (100.0, 337.5) mL vs. 325.0 (200.0, 600.0) mL], postoperative lung air leak time [3.0 (2.0, 5.0) d vs. 9.0 (6.8, 12.0) d] and the postoperative hospital stay [11.5 (8.0, 14.8) d vs. 18.0 (14.0, 22.0) d] of the single-direction group were less or shorter than those of the control group (P<0.05). There was no statistical difference between the single-direction group and the control group in the incidence of surgical complications [1 patient (3.12%) vs. 10 patients (17.86%)] or the cure rate [32 patients (100.00%) vs. 54 patients (96.43%)].Conclusion The single-direction lobectomy can reduce lung injury and bleeding, shorten the duration of operation and accelerate the postoperative recovery in patients with complicated pulmonary tuberculosis, which has certain advantages compared with traditional lobectomy.

Citation： JIANG Yuhui, SHEN Lei, DAI Xiyong. Application of single-direction lobectomy in the treatment of complicated pulmonary tuberculosis: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(12): 1607-1611. doi: 10.7507/1007-4848.202012082 Copy

1.	刘伦旭, 车国卫, 蒲强, 等. 单向式全胸腔镜肺叶切除术. 中华胸心血管外科杂志, 2008, 24(3): 156-158.
2.	Dewan RK, Pezzella AT. Surgical aspects of pulmonary tuberculosis: An update. Asian Cardiovasc Thorac Ann, 2016, 24(8): 835-846.
3.	Liao H, Mei J, Lin F, et al. Single-direction thoracoscopic lobectomy: Left side. J Thorac Dis, 2018, 10(10): 5932-5934.
4.	Liao H, Liu C, Mei J, et al. Single-direction thoracoscopic lobectomy: Right side. J Thorac Dis, 2018, 10(10): 5935-5938.
5.	Khan AZ, Khanna S, Agarwal N, et al. Robotic thoracic surgery in inflammatory and infective diseases. Ann Cardiothorac Surg, 2019, 8(2): 241-249.
6.	廖勇, 蔡青, 韦鸣, 等. 外科手术治疗74例肺结核并发肺曲菌球病患者的临床价值. 中国防痨杂志, 2019, 41(3): 260-265.
7.	丁超, 韦林, 刘玉钢, 等. 肺结核病胸腔镜肺叶切除术中非计划开胸手术原因初步分析. 临床肺科杂志, 2019, 24(9): 1665-1670.
8.	Okuda K, Haneda H, Yokota K, et al. Video-assisted thoracoscopic lobectomy for the right side using a single-direction approach. J Thorac Dis, 2019, 11(1): 65-67.
9.	詹必成, 刘建, 陈剑, 等. 单向式技术在单孔胸腔镜右肺上叶切除术中的应用. 中华胸心血管外科杂志, 2020, 36(4): 230-231.
10.	刘德纲, 蔡开灿, 赵意, 等. 全胸腔镜下单向式肺癌根治术. 南方医科大学学报, 2012, 32(1): 139-140, 封3.
11.	郭虹, 刁亚利, 范黄新, 等. 全腔镜下四孔单向式与三孔法解剖性肺叶切除治疗早期非小细胞肺癌的临床回顾性研究. 中国肺癌杂志, 2018, 21(8): 578-582.
12.	赵田, 张淼, 武文斌, 等. 单孔胸腔镜单向式解剖性右上肺切除术的临床分析. 中华解剖与临床杂志, 2019, 24(2): 176-181.
13.	蒋钰辉, 申磊, 戴希勇. 肺上叶切除术后胸内残腔发生的危险因素及其对术后早期并发症的影响. 中国防痨杂志, 2018, 40(12): 1280-1285.
14.	宋言峥, 朱益军, 陈辉, 等. 肺结核外科的微创伤疗法(附39例报告). 中华胸部外科电子杂志, 2020, 7(2): 71-75.
15.	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): 651-656.
16.	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.
17.	车勇, 常炜, 刘志刚, 等. 肺结核患者采用不同电视辅助胸腔镜术式的临床及疗效分析. 中国防痨杂志, 2017, 39(5): 468-472.
18.	齐海亮, 李明珠, 杜秀然, 等. 全胸腔镜解剖性肺段切除术治疗结核性支气管扩张症. 中国微创外科杂志, 2018, 18(9): 802-805.
19.	钱鼎烽, 尚军, 韩琼, 等. 单操作孔电视胸腔镜手术治疗肺结核合并支气管扩张. 中国微创外科杂志, 2018, 18(6): 541-544.
20.	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.
21.	宋言峥. 耐多药肺结核的外科治疗. 中华结核和呼吸杂志, 2019, 42(5): 338-342.

1. 刘伦旭, 车国卫, 蒲强, 等. 单向式全胸腔镜肺叶切除术. 中华胸心血管外科杂志, 2008, 24(3): 156-158.
2. Dewan RK, Pezzella AT. Surgical aspects of pulmonary tuberculosis: An update. Asian Cardiovasc Thorac Ann, 2016, 24(8): 835-846.
3. Liao H, Mei J, Lin F, et al. Single-direction thoracoscopic lobectomy: Left side. J Thorac Dis, 2018, 10(10): 5932-5934.
4. Liao H, Liu C, Mei J, et al. Single-direction thoracoscopic lobectomy: Right side. J Thorac Dis, 2018, 10(10): 5935-5938.
5. Khan AZ, Khanna S, Agarwal N, et al. Robotic thoracic surgery in inflammatory and infective diseases. Ann Cardiothorac Surg, 2019, 8(2): 241-249.
6. 廖勇, 蔡青, 韦鸣, 等. 外科手术治疗74例肺结核并发肺曲菌球病患者的临床价值. 中国防痨杂志, 2019, 41(3): 260-265.
7. 丁超, 韦林, 刘玉钢, 等. 肺结核病胸腔镜肺叶切除术中非计划开胸手术原因初步分析. 临床肺科杂志, 2019, 24(9): 1665-1670.
8. Okuda K, Haneda H, Yokota K, et al. Video-assisted thoracoscopic lobectomy for the right side using a single-direction approach. J Thorac Dis, 2019, 11(1): 65-67.
9. 詹必成, 刘建, 陈剑, 等. 单向式技术在单孔胸腔镜右肺上叶切除术中的应用. 中华胸心血管外科杂志, 2020, 36(4): 230-231.
10. 刘德纲, 蔡开灿, 赵意, 等. 全胸腔镜下单向式肺癌根治术. 南方医科大学学报, 2012, 32(1): 139-140, 封3.
11. 郭虹, 刁亚利, 范黄新, 等. 全腔镜下四孔单向式与三孔法解剖性肺叶切除治疗早期非小细胞肺癌的临床回顾性研究. 中国肺癌杂志, 2018, 21(8): 578-582.
12. 赵田, 张淼, 武文斌, 等. 单孔胸腔镜单向式解剖性右上肺切除术的临床分析. 中华解剖与临床杂志, 2019, 24(2): 176-181.
13. 蒋钰辉, 申磊, 戴希勇. 肺上叶切除术后胸内残腔发生的危险因素及其对术后早期并发症的影响. 中国防痨杂志, 2018, 40(12): 1280-1285.
14. 宋言峥, 朱益军, 陈辉, 等. 肺结核外科的微创伤疗法(附39例报告). 中华胸部外科电子杂志, 2020, 7(2): 71-75.
15. 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): 651-656.
16. 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.
17. 车勇, 常炜, 刘志刚, 等. 肺结核患者采用不同电视辅助胸腔镜术式的临床及疗效分析. 中国防痨杂志, 2017, 39(5): 468-472.
18. 齐海亮, 李明珠, 杜秀然, 等. 全胸腔镜解剖性肺段切除术治疗结核性支气管扩张症. 中国微创外科杂志, 2018, 18(9): 802-805.
19. 钱鼎烽, 尚军, 韩琼, 等. 单操作孔电视胸腔镜手术治疗肺结核合并支气管扩张. 中国微创外科杂志, 2018, 18(6): 541-544.
20. 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.
21. 宋言峥. 耐多药肺结核的外科治疗. 中华结核和呼吸杂志, 2019, 42(5): 338-342.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of single-direction lobectomy in the treatment of complicated pulmonary tuberculosis: A retrospective cohort study

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