原发性自发性气胸的胸腔镜治疗
Thoracoscopic management of primary spontaneous pneumothorax.
作者信息
Connolly S S, Hurson C, Lynch V
机构信息
Thoracic Surgery Unit, St Vincent's University Hospital, Dublin, Ireland.
出版信息
Ir J Med Sci. 2002 Apr-Jun;171(2):71-2. doi: 10.1007/BF03168954.
BACKGROUND
Video-assisted thoracoscopic surgery (VATS) is the preferred option for the surgical management of primary spontaneous pneumothorax (PSP).
AIMS
To evaluate the role of thoracoscopic blebectomy with and without chemical pleurodesis.
METHODS
A retrospective study was performed on 113 consecutive cases carried out in one unit. RESULTS; One hundred and thirteen VATS procedures were performed on 108 patients. The mean age was 23 years (range 14-45). The male to female ratio was 82:26. Recurrent pneumothorax was the indication for surgery in 80%. Conversion to an open procedure was required in 10 cases (9%), most commonly due to severe adhesions. Successful endoscopic blebectomy was performed in 98 cases (87%), 48 of which had an additional chemical pleurodesis. Follow-up is currently to a mean of 28 months. Recurrence has occurred in eight cases, including only three in the group managed with additional chemical pleurodesis (6.25%).
CONCLUSION
VATS with blebectomy and chemical pleurodesis is a safe and effective procedure in the management of PSP.
背景
电视辅助胸腔镜手术（VATS）是原发性自发性气胸（PSP）手术治疗的首选方法。
目的
评估胸腔镜下肺大疱切除术联合或不联合化学性胸膜固定术的作用。
方法
对一个单位连续进行的113例病例进行回顾性研究。结果：对108例患者实施了113例VATS手术。平均年龄为23岁（范围14 - 45岁）。男女比例为82:26。80%的患者手术指征为复发性气胸。10例（9%）需要转为开放手术，最常见的原因是严重粘连。98例（87%）成功实施了内镜下肺大疱切除术，其中48例还进行了化学性胸膜固定术。目前平均随访28个月。8例出现复发，其中仅3例在联合化学性胸膜固定术治疗的组中（6.25%）。
结论
VATS联合肺大疱切除术和化学性胸膜固定术是治疗PSP的一种安全有效的方法。
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