Diagnosis and surgical treatment of middle lobe disease of lung: report of 163 cases / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To discuss the principle of diagnosis and surgical treatment of middle lobe diseases of right lung.</p><p><b>METHODS</b>We analysed the clinical data and prognosis of 163 patients who suffered from middle lobe diseases of right lung and received surgical treatment.</p><p><b>RESULTS</b>There were 97 men and 66 women in the group with the ratio 1.51, whose age arranged from 13 to 74 years. The shortest course was one week, and the longest 25 years. The average course was 30.3 months. 78 of 163 patients with tumors were malignant (47.9%) and 85 benign (52.1%). The number of the patients below 50 years old was 91 and 81.3% of them were benign, which was very markedly higher than that of the patients with malignant tumors (P < 0.01). The number of the patients above 50 years old was 72 and 84.7% were malignant, which was very markedly higher than that of the patients with benign tumors (P < 0.01); 8 of 11 patients (72.7%, 8/11) who suffered from tuberculosis combined with bronchoactesis. One of this group died from respiratory failure after operation, packed accumulation of fluid between lobes happened in seven cases (4.3%). The survival rate of 1, 3, 5 years of malignant patients at stages I, II were 88.4%, 62.8%, 51.2%, for that at stages III, IV were 76.5%, 41.2%, 14.7%. All of the four patients who received vage-resection, their malignant tumors recurred in one year after operation. No benign lesion recurred in 10 years.</p><p><b>CONCLUSION</b>(1) It should be noticed that nearly half of middle lobe disease were malignant, especially to those whose ages were above 50 years old. (2) When the diagnosis is hard to be confirmed, open-thoracic exploration should be performed in order not to delay the treatment or enlarge the range of lung resection. (3) Most of middle lobe tuberculosis may be combined with bronchoactesis. (4) Setting drainage tube may be useful to decrease the risk of interlobe accumulation of fluid. (5) Vage resection is not suitable for carcinoma of middle lobe of lung.</p>