Experience of Interventional Thrombolysis Therapy for Massive Pulmonary Thrombosis Embolism after Video-assisted Thoracoscopic Surgery for Lung Cancer

• Main Authors: Shengjie JING, Jianming ZHOU, Qitong LU, Xin CHU, Wei HE, Jie JIANG, Xin XUE, Zhiyong LIU, Tao XUE
• Format: Article
• Language: zho
• Published: Chinese Anti-Cancer Association; Chinese Antituberculosis Association 2018-10-01
• Series: Chinese Journal of Lung Cancer
• Subjects: Lung neoplasms; Lobectomy; Massive pulmonary embolism; Interventional therapy; Thrombolysis
• Online Access: http://dx.doi.org/10.3779/j.issn.1009-3419.2018.10.08
• ISSN: 1009-3419; 1999-6187

Background and objective Pulmonary thrombosis embolism (PTE) is one of the most severe complications of perioperative radical mastectomy. Massive PTE is often accompanied by shock and hypotension which is characterized by rapid progression and high mortality. There is no standard for the treatment of these patients, which is thoracic surgery, and it is a critical issue in the thoracic surgeons. This article summarizes and analyzes the treatment of two patients with high-risk PTE at the early stage of postoperative lung cancer in our hospital. In addition, we discusses the diagnosis and treatment strategies of these cases to provide a reference for the thoracic surgeons. Methods We presented two patients with high-risk PTE at the early stage after thoracic surgery for radical surgery in our hospital back in 2017. One case was treated with intravenous venous interventional thrombolysis, and the other was treated with thrombolysis alone. The treatment effect of two patients and the complications during the treatment has been recorded to detail and summarized. Results Both patients were female who aged 66 and 61 years old. The time point of pulmonary embolism was 48 h and 45 h after operation, and the time of interventional thrombolysis was 70 minutes and 50 minutes after onset respectively. After 120 minutes and 100 minutes, the drainage after interventional thrombolysis was 4,690 mL and 520 mL respectively. The hospitalization time after thrombolysis was 21 days and 14 days respectively. There was no obvious complication through a follow-up of 6 months. Conclusion Early postoperative acute massive pulmonary embolism in lung cancer should be treated with pulmonary interventional thrombolysis as soon as possible. Compared with intravenous thrombolysis, pulmonary interventional thrombolysis shows accuracy, easy controlling of dosage, fast curative effect and low bleeding risk.