Ran Bo, Li Quan, Li Cheng, Li Ming, Chen Jia-Yu, Wang Li-Xin, Qiao Yue-Hua, Guan Jun-Hui, Wang Zhi-Wei
Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu Province, China.
Department of Orthopedics, Changhai Hospital Affiliated to Second Military Medical University, Shanghai, China.
Thorac Cardiovasc Surg. 2015 Aug;63(5):437-42. doi: 10.1055/s-0033-1361086. Epub 2014 Jul 4.
Anterior thoracoscopic release combined with posterior correction is a common surgery to treat idiopathic scoliosis (IS). However, whether it has detrimental effects on pulmonary function is still unknown.
The aim of the study is to evaluate the effect of anterior thoracoscopic release combined with posterior correction on the pulmonary function. Materials and Methods A retrospective study of 28 (12 male, 16 female) patients with IS undergoing anterior thoracoscopic release combined with posterior correction from 2009 to 2011 was performed. The radiographic and pulmonary function evaluations were performed preoperatively and at 24 months postoperatively.
The average coronal Cobb angle was corrected from 88.36 ± 25.6 degrees to 49.8 ± 11.8 degrees, and average sagittal Cobb angle was corrected from 57.5 ± 17.2 degrees to 26.3 ± 4.7 degrees. The measured forced vital capacity (FVC) and total lung capacity (TLC) were significantly increased at 2 years postoperatively (3.21 ± 1.18 versus 2.47 ± 0.33; 4.32 ± 1.41 versus 3.68 ± 0.36; p < 0.01). However, no significant difference in the FVC% and TLC% was observed. The functional residual capacity percentage was 109.87 ± 14.87 preoperatively and increased to 118.56 ± 34.34 at 2 years postoperatively (p < 0.05). Both the measured residual volume (RV) and RV% were reduced postoperatively (p < 0.05). The maximum ventilatory volume percentage improved significantly (107.38 ± 39.22 versus 77.46 ± 12.37, p < 0.05). In addition, total airway resistance, inhaled airway resistance, and exhaled airway resistance were all decreased significantly.
Anterior thoracoscopic release combined with posterior correction has proved to be a safe surgical technique that results in minor pulmonary function impairment.
胸腔镜前路松解联合后路矫正术是治疗特发性脊柱侧凸(IS)的常见手术。然而,其对肺功能是否有不良影响仍不清楚。
本研究旨在评估胸腔镜前路松解联合后路矫正术对肺功能的影响。材料与方法 对2009年至2011年期间接受胸腔镜前路松解联合后路矫正术的28例(男12例,女16例)IS患者进行回顾性研究。术前及术后24个月进行影像学和肺功能评估。
平均冠状面Cobb角从88.36±25.6度矫正至49.8±11.8度,平均矢状面Cobb角从57.5±17.2度矫正至26.3±4.7度。术后2年时,实测用力肺活量(FVC)和肺总量(TLC)显著增加(3.21±1.18对2.47±0.33;4.32±1.41对3.68±0.36;p<0.01)。然而,FVC%和TLC%未观察到显著差异。功能残气量百分比术前为109.87±14.87,术后2年增至118.56±34.34(p<0.05)。术后实测残气量(RV)和RV%均降低(p<0.05)。最大通气量百分比显著改善(107.38±39.22对77.46±12.37,p<0.05)。此外,总气道阻力、吸气气道阻力和呼气气道阻力均显著降低。
胸腔镜前路松解联合后路矫正术已被证明是一种安全的手术技术,对肺功能的损害较小。