Background: Treatment of tuberculous-destroyed lung (TDL) with pleuropulmonary resection is challenging. Pulmonary hemorrhage is a frequent complication of this surgical procedure. Continuous efforts have been made to investigate clinical procedures that may reduce intraoperative bleeding effectively. In this study, we evaluated the feasibility and safety of regional arterial embolization before pleuropulmonary resection in patients with TDL.
Methods: The clinical data of 32 patients with TDL were retrospectively reviewed and analyzed. These patients were admitted to the hospital between July 2009 and November 2016. All of the patients had moderate to massive hemoptysis and received regional arterial embolization in affected areas. Then, these patients underwent pleuropulmonary resection within 1 week to 2 months after embolization.
Results: The results showed that 25 patients (78.1%) had bronchial artery, and all patients had non-bronchial systemic artery found in affected areas. Mild to moderate chest pain was reported in 6 patients, and fever was reported in 2 patients. Intraoperative blood loss during pleuropulmonary resection in patients who had received preoperative regional arterial embolization was 625.6 ± 352.6 ml. Duration of the operation was 120.3 ± 75.2 min. Bronchopleural fistulae and empyema were found in 3 cases (9.4%).
Conclusion: Performance of regional arterial embolization before pleuropulmonary resection offers a safe and feasible option that reduces intraoperative blood loss and shortens operative time in patients with TDL.
Keywords: Pleuropulmonary resection; Regional arterial embolization; Tuberculous destroyed lung.