成人非囊性纤维化支气管扩张的节段切除术与肺叶切除术的结果。

IF 2.9 4区 医学 Q2 RESPIRATORY SYSTEM Jornal Brasileiro De Pneumologia Pub Date : 2025-01-13 eCollection Date: 2025-01-01 DOI:10.36416/1806-3756/e20240301
José de Sá Moraes Neto, Isabele Alves Chirichela, Alessandro Wasum Mariani, Ricardo Mingarini Terra, Paulo Manuel Pêgo Fernandes
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引用次数: 0

摘要

目的:对于出现咯血或化脓的支气管扩张患者,以及对临床治疗无效的患者,手术切除仍然是金标准治疗方法。我们试图探讨肺叶下切除术(节段切除术)的疗效,并将其与肺叶切除术(肺叶切除术)在非囊性纤维化支气管扩张患者中的疗效进行比较。方法:纳入2019 - 2023年间接受肺叶切除术或节段切除术的患者。我们分析术中并发症和术后结果,包括住院时间、ICU住院时间和疾病复发。结果:肺叶切除术组与节段切除术组术中出血> 1000 ml、心源性休克、通气不稳定等并发症的发生差异无统计学意义(p > 0.999)。然而,并发症发生率在节段切除术组明显低于肺叶切除术组(p = 0.016)。肺叶切除术组住院时间长于节段切除术组(16天比5天;p = 0.027), ICU住院时间(7天vs 1天;P = 0.006)。肺叶切除术组与节段切除术组复发率差异无统计学意义(p = 0.541)。结论:早期识别适合手术切除的支气管扩张患者至关重要,因为早期识别的患者可以选择保留实质的切除,这与疾病控制方面的大叶切除相似,可以缩短住院时间和改善术后效果。
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Outcomes of segmentectomy versus lobectomy in adults with non-cystic fibrosis bronchiectasis.

Objective: Surgical resection remains the gold standard treatment for bronchiectasis in patients who present with hemoptysis or suppuration, as well as in those who do not respond to clinical treatment. We sought to investigate the efficacy of sublobar resection (segmentectomy) and compare it with that of lobar resection (lobectomy) in patients with non-cystic fibrosis bronchiectasis.

Methods: Patients undergoing lobectomy or segmentectomy between 2019 and 2023 were included in the study. We analyzed intraoperative complications and postoperative outcomes, including length of hospital stay, length of ICU stay, and disease recurrence.

Results: There was no significant difference between the lobectomy and segmentectomy groups regarding the occurrence of intraoperative complications such as bleeding > 1000 ml, cardiogenic shock, and ventilatory instability (p > 0.999). However, the frequency of complications was significantly lower in the segmentectomy group than in the lobectomy group (p = 0.016). Hospital stays were longer in the lobectomy group than in the segmentectomy group (16 days vs. 5 days; p = 0.027), as were ICU stays (7 days vs. 1 day; p = 0.006). There was no significant difference between the lobectomy and segmentectomy groups regarding the recurrence rate (p = 0.541).

Conclusions: Early identification of bronchiectasis patients who are candidates for surgical resection is essential because those who are identified as such early on are candidates for parenchyma-sparing resections, which are similar to lobar resections in terms of disease control and lead to shorter hospital stays and better postoperative outcomes.

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来源期刊
Jornal Brasileiro De Pneumologia
Jornal Brasileiro De Pneumologia RESPIRATORY SYSTEM-
CiteScore
3.50
自引率
14.80%
发文量
118
审稿时长
20 weeks
期刊介绍: The Brazilian Journal of Pulmonology publishes scientific articles that contribute to the improvement of knowledge in the field of the lung diseases and related areas.
期刊最新文献
Brazilian Thoracic Association recommendations for the management of lymphangioleiomyomatosis. Joint statement on evidence-based practices in mechanical ventilation: suggestions from two Brazilian medical societies. Incidence rate, clinical profile, and outcomes of COVID-19 in adults with non-cystic fibrosis bronchiectasis. Life-threatening pulmonary embolism seen as hyperdense clots on unenhanced CT. A new era of cystic fibrosis therapy with CFTR modulators.
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