文章摘要

亚肺叶切除术及其术后缘增厚的鉴别

作者: 1郑佳杰, 1孙志勇, 1唐健, 1叶清, 1傅于捷, 1曹子昂, 1赵晓菁
1 上海交通大学医学院附属仁济医院胸外科,上海 200123
通讯: 赵晓菁 Email: zhaoxiaojing@renji.com
DOI: 10.3978/j.issn.2095-6959.2022.09.035

摘要

近年来,随着低剂量螺旋CT的广泛使用以及居民自身保健意识的增强,早期肺癌的检出率明显提高,越来越多的肺癌患者在早期被诊断发现并得到治疗。亚肺叶切除术可以更好地保存患者术后的肺功能并提高生活质量,运用也逐渐增多。但亚肺叶切除术在具有这些优点的同时,其手术后复发案例也伴随着逐渐升高,其中切缘复发就是十分值得注意的要点。为了解决这一问题,学者各自进行回顾性或者前瞻性研究,但观点存在出入。同时,还有一点值得注意的是,并不是所有出现术后切缘增厚所并形成的团块均意味着切缘复发,切缘周围形成肉芽肿的情况也十分常见。因此,亚肺叶切除术后切缘肉芽肿和切缘复发的鉴别诊断具有重要的临床意义。目前已有的各项针对术后复查(如PET、CT、MRI)的研究结果均存在一定的局限性。
关键词: 亚肺叶切除术;肺癌;切缘复发;肉芽肿

Sublobar resection and the identification of postoperative thickening of the margin

Authors: 1ZHENG Jiajie, 1SUN Zhiyong, 1TANG Jian, 1YE Qing, 1FU Yujie, 1CAO Ziang, 1ZHAO Xiaojing
1 Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200123, China

CorrespondingAuthor: ZHAO Xiaojing Email: zhaoxiaojing@renji.com

DOI: 10.3978/j.issn.2095-6959.2022.09.035

Abstract

In recent years, with the popularization of low-dose CT and the enhancement of residents’ health care awareness, the discovery and detection rate of early-stage lung cancer has increased significantly. More and more lung cancer patients have been diagnosed and treated at an early stage. Because of better preservation of postoperative pulmonary function and better quality of life, the application of sublobar resection is also gradually increasing. Though sublobar resection has many advantages, the cases of postoperative recurrence also increase gradually at the same time. The recurrence at the margin is one of the key point worth noting. In order to solve this problem, some scholars have conducted retrospective or prospective research, but there are differences in their views. On the other hand, it is also worth noting that not all the postoperative masses appeared on the margin indicate recurrence, and the postoperative granuloma around the cutting edge is also quite common. Therefore, the differential diagnosis of marginal granuloma and marginal recurrence after sublobar resection has important clinical significance. At present, the existing research of postoperative examination (such as PET, CT, MRI) have certain limitations.

Keywords: sublobar resection; lung cancer; margin recurrence; granuloma

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