Pulmonary hamartoma resection

In 1906, Hart first reported pulmonary hamartoma, ranking first in benign lung tumors, and Arrigoni et al (1970) reported 77%. Its pathological feature is the abnormal combination and arrangement of normal tissues. Its source and pathogenesis are still unknown. Some people think that hamartoma is a tissue that constitutes the bronchus. It reverses, falls off during embryonic development, and is surrounded by normal lung tissue. Hamartomas grow very slowly, Hansen et al. (1992) reported that their growth rate is usually 3.2 ± 2.6 mm / year. The components of hamartoma are mainly cartilage, which accounts for the majority. Therefore, there are also called "chondroma" or "chondral mucinous hamartoma". Adipose tissue is also more common, as well as smooth muscle fibers, glands and epithelial cells. 90% of the lung hamartomas are single in the peripheral part of the lung, and multiple pulmonary hamartomas are occasionally reported. 8% to 10% of the lung hamartoma grows in the bronchi. There are reports of malignant transformation of lung hamartoma in the literature, but it is difficult to be convinced by lack of evidence. Pulmonary hamartoma If the diagnosis is clear, especially if there is a histological diagnosis of lung puncture, it is okay to observe for a period of time without surgery. Surgical treatment should be performed immediately if the tumor grows significantly during the observation period. If the diagnosis is not clear, a resection should be performed. Because: 1 can not exclude lung cancer, tuberculoma or other benign tumors; 2 patients, especially the endobronchial type have obvious respiratory and systemic symptoms; 3 many patients have a large psychological burden due to unclear diagnosis; 4 lung cancer and lung The relationship between hamartomas is not yet clear. KarsiK et al (1980) reported that patients with pulmonary hamartoma had 6.3 times more chance of developing bronchial lung cancer (simultaneously or at different times) than normal people, and they believed that they had an etiology connection. Vanden Bosch et al (1987) found 6 cases of simultaneous type and 5 cases of metachronous bronchogenic carcinoma in 154 patients with pulmonary hamartoma, the incidence rate was 7%. However, they think this is a coincidence. Peripheral pulmonary hamartoma, especially those less than 3 cm in diameter, are suitable for thoracoscopic surgical resection, while others choose the thoracotomy. Treatment of diseases: pulmonary hamartoma Indication Pulmonary hamartoma. Preoperative preparation Prepare routinely before surgery. Surgical procedure Incision A small incision in the chest is used, and if necessary, it is extended to a standard open chest incision. 2. Tumor removal The hamartoma around the lungs can slide back and forth in the lung parenchyma, push it as far as possible under the pleura of the lung surface, cut the visceral pleura and a little lung tissue, and easily remove the tumor. The visceral pleural and lung tissues of the incision were sutured with thin lines. 3. Pneumonectomy The position of the hamartoma is deep, and if it is not fixed, it should be performed with wedge resection, segmental resection or even lobectomy. Pneumonectomy should be avoided. 4. Bronchial incision, tumor removal or bronchoplasty Intrabronchial hamartoma, if the lung tissue at the distal end of the lesion is normal, such surgery should be performed. Otherwise, the lung segment or lobectomy should be performed. Postoperative diet 1. Eat foods rich in high quality protein; 2. Eat foods rich in carbohydrates; 3. It is advisable to eat foods rich in vitamins and dietary fiber; 4. Avoid spicy foods.