Ishikawa Yoshihiro, Yamanaka Kazuki, Nishii Teppei, Fujii Keita, Rino Yasushi, Maehara Takamitsu
Department of General Thoracic Surgery, Yokohama Rosai Hospital, 3211 Kozukuecho, Kohoku-ku, Yokohama, 222-0036, Japan.
Gen Thorac Cardiovasc Surg. 2008 Apr;56(4):187-90. doi: 10.1007/s11748-007-0215-6. Epub 2008 Apr 10.
We experienced five cases of pulmonary arteriovenous malformations (PAVMs) that were successfully treated by video-assisted thoracoscopic surgery. Four malformations were treated by local wedge resection and one was treated by segmentectomy. Criteria for patient selection for surgery were peripheral and solitary lesions, with feeding arteries larger than 3 mm. Postoperative hospital stays were 1-7 days (median, 2 days). All patients showed unchanged or increased values of PaO(2) in arterial blood after operation. No major postoperative complication occurred in any patient, but a persistent air leak for 5 days occurred in the one patient who was treated by segmentectomy. No growth of accessory vessels or untreated malformations were seen in any patient throughout the follow-up period of 14-54 months. Thoracoscopic surgical resection for well-selected patients provides a high certainty of eliminating fistulae and was associated with lower morbidity, lower mortality, and shorter hospital stays.
我们经历了5例通过电视辅助胸腔镜手术成功治疗的肺动静脉畸形（PAVM）。4例畸形通过局部楔形切除术治疗，1例通过肺段切除术治疗。手术患者选择标准为外周孤立性病变，供血动脉大于3毫米。术后住院时间为1 - 7天（中位数为2天）。所有患者术后动脉血中PaO(2)值未变或升高。所有患者均未发生重大术后并发症，但接受肺段切除术的1例患者出现了持续5天的漏气。在14 - 54个月的随访期内，所有患者均未发现附属血管生长或未治疗的畸形。对于精心挑选的患者，胸腔镜手术切除可高度确定地消除瘘管，且发病率低、死亡率低、住院时间短。
