Rationale:Vanishing lung syndrome is rare and can be associated with a history of smoking and marijuana use.The occurrence of giant bullae can also be linked to infections,particularly tuberculosis in tropical countri...Rationale:Vanishing lung syndrome is rare and can be associated with a history of smoking and marijuana use.The occurrence of giant bullae can also be linked to infections,particularly tuberculosis in tropical countries.Patient concerns:A 26-year-old male complained of weakness,severe vomiting,and reduced breathlessness when lying on the left side.He had a history of pulmonary tuberculosis two years ago.Diagnosis:Symptomatic bradycardia in tuberculosis-related giant bullae.Interventions:The patient was recommended to undergo an elective bullectomy,but he decided not to proceed with the procedure.Atropine sulfate was administered to alleviate symptoms of bradycardia,while a standardized anti-tuberculosis regimen were started for the next six months.Outcomes:Following 7 days of intensive care treatment involving antituberculosis medications and atropine sulfate,the patient achieved hemodynamic stability,opting against bullectomy despite residual symptoms of dyspnea.Subsequent six months of antituberculosis therapy notably alleviated symptoms without requiring bullectomy.Lessons:Increasing intrathoracic pressure can also be caused mechanically by giant bullae.Cardiac symptoms in vanishing lung syndrome are reversible and can be alleviated once the underlying cause is addressed.In this case,symptomatic bradycardia was reduced only with tuberculosis treatment without bullectomy intervention。展开更多
A 67-year-old man was referred for further evaluation of an abnormal chest roentgenogram. Computed tomography showed a 40 × 30 mm mass in the left upper lobe. A giant bulla occupying about two-thirds of the right...A 67-year-old man was referred for further evaluation of an abnormal chest roentgenogram. Computed tomography showed a 40 × 30 mm mass in the left upper lobe. A giant bulla occupying about two-thirds of the right thorax was found compressing the adjacent lung parenchyma, shifting the mediastinum to the left. The mass was a primary lung cancer, clinical T2aN0M0, stage IB. Preoperative respiratory function evaluation showed poor pulmonary function, with a forced expiratory volume in 1 second of 1070 ml (29.2% of predicted). Therefore, we first performed giant bullectomy by video-assisted thoracoscopic surgery. At 1 month after this operation, improvement of the forced expiratory volume in 1 second significantly to 2140 ml (80.1% of predicted) was observed. Therefore, we performed resection for the tumor. He was discharged after an uneventful postoperative course, and has remained in good condition for 6 months after the operation.展开更多
Objective:To explore an effective treatment for spontaneous progressive hemopneumothorax in young people.Methods:Thirty-four young patients with spontaneous progressive hemopneumothorax from January 2018 to December 2...Objective:To explore an effective treatment for spontaneous progressive hemopneumothorax in young people.Methods:Thirty-four young patients with spontaneous progressive hemopneumothorax from January 2018 to December 2019 were selected to be included in the control group for retrospective analysis;from January 2020 to December 2021,69 young patients with spontaneous progressive hemopneumothorax were selected to be included in the study group.The control group was treated with double-port thoracoscopic bullectomy,whereas the study group was treated with single-port thoracoscopic bullectomy.The intraoperative blood loss,operation time,tube retention time,VAS score,postoperative air leakage,and 1-year recurrence of the patients in the two groups were observed and analyzed.Results:The perioperative conditions of the patients in the study group,including intraoperative bleeding loss,operation time,tube retention time,and VAS scores,were 15.12±1.36,54.69±18.78,2.14±0.98,and 3.25±0.14,respectively.The perioperative conditions of the patients in the control group,including intraoperative bleeding loss,operation time,tube retention time,and VAS scores,were 22.69±2.01,55.36±19.01,4.21±1.01,and 5.36±0.45,respectively;other than the operation time,the differences in intraoperative blood loss,tube retention time,and VAS scores between the two groups were statistically significant(p<0.05);after the surgery,two patients in the study group had postoperative air leakage,accounting for 2.90%and another two patients had recurrence one year after the surgery,accounting for 2.90%;on the other hand,three patients in the control group had postoperative air leakage,accounting for 8.82%,and two patients had recurrence one year after the surgery,accounting for 5.88%.However,χ^(2) test showed that p>0.05.Conclusion:Treatment of spontaneous progressive hemopneumothorax in young people is better with single-port thoracoscopic bullectomy than with two-port thoracoscopic bullectomy,which effectively reduces intraoperative bleeding.The pain level is significantly better with single-port thoracoscopic bullectomy than with two-port thoracoscopic bullectomy,and the prognosis of patients is good with a low probability of recurrence for both,single-and twoport thoracoscopic bullectomy.展开更多
文摘Rationale:Vanishing lung syndrome is rare and can be associated with a history of smoking and marijuana use.The occurrence of giant bullae can also be linked to infections,particularly tuberculosis in tropical countries.Patient concerns:A 26-year-old male complained of weakness,severe vomiting,and reduced breathlessness when lying on the left side.He had a history of pulmonary tuberculosis two years ago.Diagnosis:Symptomatic bradycardia in tuberculosis-related giant bullae.Interventions:The patient was recommended to undergo an elective bullectomy,but he decided not to proceed with the procedure.Atropine sulfate was administered to alleviate symptoms of bradycardia,while a standardized anti-tuberculosis regimen were started for the next six months.Outcomes:Following 7 days of intensive care treatment involving antituberculosis medications and atropine sulfate,the patient achieved hemodynamic stability,opting against bullectomy despite residual symptoms of dyspnea.Subsequent six months of antituberculosis therapy notably alleviated symptoms without requiring bullectomy.Lessons:Increasing intrathoracic pressure can also be caused mechanically by giant bullae.Cardiac symptoms in vanishing lung syndrome are reversible and can be alleviated once the underlying cause is addressed.In this case,symptomatic bradycardia was reduced only with tuberculosis treatment without bullectomy intervention。
文摘A 67-year-old man was referred for further evaluation of an abnormal chest roentgenogram. Computed tomography showed a 40 × 30 mm mass in the left upper lobe. A giant bulla occupying about two-thirds of the right thorax was found compressing the adjacent lung parenchyma, shifting the mediastinum to the left. The mass was a primary lung cancer, clinical T2aN0M0, stage IB. Preoperative respiratory function evaluation showed poor pulmonary function, with a forced expiratory volume in 1 second of 1070 ml (29.2% of predicted). Therefore, we first performed giant bullectomy by video-assisted thoracoscopic surgery. At 1 month after this operation, improvement of the forced expiratory volume in 1 second significantly to 2140 ml (80.1% of predicted) was observed. Therefore, we performed resection for the tumor. He was discharged after an uneventful postoperative course, and has remained in good condition for 6 months after the operation.
基金Baoding Science and Technology Planning Project(Project Number:1941ZF088)。
文摘Objective:To explore an effective treatment for spontaneous progressive hemopneumothorax in young people.Methods:Thirty-four young patients with spontaneous progressive hemopneumothorax from January 2018 to December 2019 were selected to be included in the control group for retrospective analysis;from January 2020 to December 2021,69 young patients with spontaneous progressive hemopneumothorax were selected to be included in the study group.The control group was treated with double-port thoracoscopic bullectomy,whereas the study group was treated with single-port thoracoscopic bullectomy.The intraoperative blood loss,operation time,tube retention time,VAS score,postoperative air leakage,and 1-year recurrence of the patients in the two groups were observed and analyzed.Results:The perioperative conditions of the patients in the study group,including intraoperative bleeding loss,operation time,tube retention time,and VAS scores,were 15.12±1.36,54.69±18.78,2.14±0.98,and 3.25±0.14,respectively.The perioperative conditions of the patients in the control group,including intraoperative bleeding loss,operation time,tube retention time,and VAS scores,were 22.69±2.01,55.36±19.01,4.21±1.01,and 5.36±0.45,respectively;other than the operation time,the differences in intraoperative blood loss,tube retention time,and VAS scores between the two groups were statistically significant(p<0.05);after the surgery,two patients in the study group had postoperative air leakage,accounting for 2.90%and another two patients had recurrence one year after the surgery,accounting for 2.90%;on the other hand,three patients in the control group had postoperative air leakage,accounting for 8.82%,and two patients had recurrence one year after the surgery,accounting for 5.88%.However,χ^(2) test showed that p>0.05.Conclusion:Treatment of spontaneous progressive hemopneumothorax in young people is better with single-port thoracoscopic bullectomy than with two-port thoracoscopic bullectomy,which effectively reduces intraoperative bleeding.The pain level is significantly better with single-port thoracoscopic bullectomy than with two-port thoracoscopic bullectomy,and the prognosis of patients is good with a low probability of recurrence for both,single-and twoport thoracoscopic bullectomy.
