Kaiser D
Pneumologie. 1989 Feb;43(2):101-4.
The article reports on the results of surgical thoracoscopy using the mediastinoscope in relapsing spontaneous pneumothorax and persisting spontaneous pneumothorax. This surgical method is performed under intubation anesthesia. Existing changes such as emphysematous bullae or fused strands are removed or cut. The parenchymatous defects occurring after surgical removal of bullae are bonded by means of 2 ml fibrin adhesive. 75% of the patients treated in this manner remain free from recurrences so that it was not necessary to perform thoracotomy although this had been originally indicated. Measures for pleurodesis that are not "on target" must be rejected, since they do not help in removing the morphological changes at the lung surface. Surgical thoracoscopy as described is, therefore, in some cases an alternative to classical thoracotomy.
本文报道了使用纵隔镜进行手术胸腔镜检查治疗复发性自发性气胸和持续性自发性气胸的结果。该手术方法在插管麻醉下进行。切除或切断存在的肺气肿大疱或粘连条索等病变。手术切除大疱后出现的实质缺损用2毫升纤维蛋白粘合剂粘合。以这种方式治疗的患者中有75%未复发,因此尽管最初曾建议进行开胸手术,但已无必要。必须摒弃那些“未针对目标”的胸膜固定术措施,因为它们无助于消除肺表面的形态学改变。因此,所述的手术胸腔镜检查在某些情况下可替代传统的开胸手术。