Kim Sung Jun, Lee Hee-Sung, Kim Hyoung-Soo, Shin Ho-Seung, Lee Jae-Woong, Kim Kun-Il, Cho Sung-Woo, Lee Won Yong
Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University, Korea.
Korean J Thorac Cardiovasc Surg. 2011 Jun;44(3):225-8. doi: 10.5090/kjtcs.2011.44.3.225. Epub 2011 Jun 11.
Conventional treatment (i.e. chest tube insertion and chemical pleurodesis) still remains standard for patients with secondary spontaneous pneumothorax because the risk of surgical bullectomy is deemed high in this subset. However, it has been suggested that surgical treatment using thoracoscopy may expedite postoperative recovery and, thus, may reduce hospital stay.
Retrospective review of 61 patients with secondary spontaneous pneumothorax, who underwent conventional treatment (n=39) or video-assisted thoracoscopic surgery (VATS) (n=22) between January 2007 and December 2009, was performed. Talc was used for chemical pleurodesis in both groups.
Hospital stay of conventional treatment group and VATS group was 14.2±14.2 days (458 days) and 10.6±5.8 days (532 days), respectively, with statistically significant difference (p=0.033). Recurrence rate of conventional treatment group was also significantly higher (12/39, 30%) compared to VATS group (1/22, 4.5%) (p=0.016).
In selected patients with secondary spontaneous pneumothorax with continuous air leak or inadequate lung expansion, thoracoscopic surgery with chemical pleurodesis using talc results in shorter hospital stay and lower recurrence rate compared to conventional approach.
对于继发性自发性气胸患者，传统治疗方法（即胸腔闭式引流术和化学性胸膜固定术）仍是标准治疗方案，因为在这一亚组患者中，手术切除肺大疱的风险被认为较高。然而，有人提出，使用胸腔镜的手术治疗可能会加快术后恢复，从而缩短住院时间。
对2007年1月至2009年12月期间接受传统治疗（n = 39）或电视辅助胸腔镜手术（VATS）（n = 22）的61例继发性自发性气胸患者进行回顾性研究。两组均使用滑石粉进行化学性胸膜固定术。
传统治疗组和VATS组的住院时间分别为14.2±14.2天（458天）和10.6±5.8天（532天），差异有统计学意义（p = 0.033）。传统治疗组的复发率（12/39，30%）也显著高于VATS组（1/22，4.5%）（p = 0.016）。
对于部分存在持续漏气或肺复张不全的继发性自发性气胸患者，与传统方法相比，使用滑石粉进行化学性胸膜固定术的胸腔镜手术可缩短住院时间并降低复发率。
