Institutional Insights into the Management and Surgical Resection of Tracheobronchial Lesions: Experience with 11 Patients.

IF 0.6 Q4 ONCOLOGY
Indian Journal of Surgical Oncology Pub Date : 2025-02-01 Epub Date: 2024-09-24 DOI:10.1007/s13193-024-02101-x
Naveen Kumar Kushwaha, Pradeep Jaiswal, Vijay Pratap Singh, S Harish, Prashant Gupta
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引用次数: 0

Abstract

Pathologic conditions affecting the central airways encompass a wide array of focal alterations. The diagnosis of central airway lesions poses considerable challenges due to their varied presentations, resulting in delayed recognition and management. However, advances in bronchoscopy and multidetector computed tomography (MDCT) aid in early detection. Management depends both on the pathology and the obstructive potential of the process. We present our experience with the comprehensive evaluation and management of 11 cases of focal tracheobronchial lesions surgically treated at our institution, with an emphasis on lung parenchyma preservation. This is a retrospective analysis of prospectively maintained data of 11 patients who were surgically treated for focal tracheobronchial lesions between January 2021 and December 2023 at a tertiary care hospital in India. Their demographic data, clinical presentation, and perioperative details were recorded. All patients underwent MDCT chest, bronchoscopy, and pulmonary function tests as part of the workup for diagnosis and assessment. The study included nine male and two female patients with a mean age of 36.4 years (range 9-64 years). Surgical procedures included main bronchus sleeve resection (3 patients), sleeve lobectomies (3 patients), sleeve bi-lobectomy (1 patient), and tracheal resection with end-to-end anastomosis (4 patients). Postoperatively, one patient died due to acute respiratory distress syndrome (ARDS). Pathological evaluation revealed malignant causes in 9 patients and non-neoplastic causes in 2 patients. The mean hospital stay was 6.5 days, with chest tube removal at 5.6 days. The average follow-up period was 8.2 months, ranging from 6 to 15 months. Based on our series, we ascertain that a complete resection, whenever feasible, offers optimal potential benefits and symptom alleviation for individuals with focal tracheobronchial lesions. Enhanced recognition of these lesions, coupled with a heightened level of suspicion and prompt diagnosis, stands pivotal in ensuring the safe and efficacious management of such cases.

11例气管支气管病变的治疗和手术切除的临床体会。
影响中央气道的病理条件包括广泛的局灶性改变。中央气道病变的诊断由于其不同的表现提出了相当大的挑战,导致延迟识别和管理。然而,支气管镜检查和多探测器计算机断层扫描(MDCT)的进步有助于早期发现。治疗取决于病理和过程的阻碍潜力。我们介绍了我们在本院手术治疗的11例局灶性气管支气管病变的综合评估和管理经验,重点是肺实质的保存。这是一项回顾性分析,对2021年1月至2023年12月在印度一家三级医院接受局灶性气管支气管病变手术治疗的11例患者的前瞻性数据进行了回顾性分析。记录患者的人口学资料、临床表现和围手术期细节。所有患者均接受多层螺旋ct胸部检查、支气管镜检查和肺功能检查,作为诊断和评估的一部分。该研究包括9名男性和2名女性患者,平均年龄36.4岁(范围9-64岁)。手术方式包括主支气管套筒切除术(3例)、肺叶套筒切除术(3例)、双肺叶套筒切除术(1例)、气管端到端吻合切除术(4例)。术后1例患者死于急性呼吸窘迫综合征(ARDS)。病理诊断为恶性9例,非肿瘤2例。平均住院时间为6.5天,拔胸管为5.6天。平均随访时间8.2个月,6 ~ 15个月不等。基于我们的系列研究,我们确定,只要可行,完全切除可为局灶性气管支气管病变患者提供最佳的潜在益处和症状缓解。加强对这些病变的认识,加上提高怀疑程度和及时诊断,对于确保安全有效地管理这类病例至关重要。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
190
期刊介绍: The Indian Journal of Surgical Oncology aims to encourage and promote clinical and research activities pertaining to Surgical Oncology. It also aims to bring in the concept of multidisciplinary team approach in management of various cancers. The Journal would publish original article, point of technique, review article, case report, letter to editor, profiles of eminent teachers, surgeons and instititions - a short (up to 500 words) of the Cancer Institutions, departments, and oncologist, who founded new departments.
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