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, Nu?ez 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.	唐神結, 許紹發, 李亮, 主編. 耐藥結核病學. 北京: 人民衛生出版社, 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.	王興安, 丁嘉安, 鄭華. 大咯血的急診外科治療. 中國急救醫學, 2004, 24(5): 332-334.
6.	唐文, 拜都如拉·艾尼吐, 付毅, 等. 肺結核大咯血 27 例急診外科治療分析. 臨床外科雜志, 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.	黃明聲, 單鴻. 超選擇性支氣管動脈栓塞治療肺結核大咯血的價值. 介入放射學雜志, 2000, 9(2): 79-81.
10.	張守民, 李景英, 王國興. 支氣管動脈栓塞治療肺結核咯血的療效及復發原因分析. 介入放射學雜志, 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. 支氣管擴張癥和肺結核咯血患者介入治療效果比較. 中華結核和呼吸雜志, 2012, 35(6): 447-449.
13.	Halezero?lu 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, 劉大偉, 金鋒, 等. 頑固性咯血患者肺葉切除術前行動脈栓塞介入治療的價值. 中國防癆雜志, 2018, 40(12): 1258-1261.

1. Cordovilla R, Bollo de Miguel E, Nu?ez 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. 唐神結, 許紹發, 李亮, 主編. 耐藥結核病學. 北京: 人民衛生出版社, 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. 王興安, 丁嘉安, 鄭華. 大咯血的急診外科治療. 中國急救醫學, 2004, 24(5): 332-334.
6. 唐文, 拜都如拉·艾尼吐, 付毅, 等. 肺結核大咯血 27 例急診外科治療分析. 臨床外科雜志, 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. 黃明聲, 單鴻. 超選擇性支氣管動脈栓塞治療肺結核大咯血的價值. 介入放射學雜志, 2000, 9(2): 79-81.
10. 張守民, 李景英, 王國興. 支氣管動脈栓塞治療肺結核咯血的療效及復發原因分析. 介入放射學雜志, 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. 支氣管擴張癥和肺結核咯血患者介入治療效果比較. 中華結核和呼吸雜志, 2012, 35(6): 447-449.
13. Halezero?lu 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, 劉大偉, 金鋒, 等. 頑固性咯血患者肺葉切除術前行動脈栓塞介入治療的價值. 中國防癆雜志, 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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