Huang Chao-Lin, Zhang Wei, Ni Zheng-Yi, Zuo Tao, Zhou Mi, Xu Jun, Yang Zhi-Feng, Li Lei, Xiao Jun, Zhang Ding-Yu
Department of Thoracic Surgery, Wuhan Medical Treatment Center 1 Yintan Road, Dongxihu District, Wuhan 430023, Hubei Province, People's Republic of China.
Intensive Care Unit, Wuhan Medical Treatment Center 1 Yintan Road, Dongxihu District, Wuhan 430023, Hubei Province, People's Republic of China.
Int J Clin Exp Med. 2015 Oct 15;8(10):18391-8. eCollection 2015.
Incompleteness of interlobar fissures and pleural adhesions, common in tuberculous destroyed lung (TDL), are among "technical contraindications" for video-assisted thoracoscopic surgery (VATS). The efficacy and safety of VATS in the treatment of TDL, has not yet been detailed in.
The objective of the present study is to observe the efficacy and safety of VATS in the management of TDL.
A retrospective review of anatomic lobectomy by VATS on 29 cases of TDL was performed in the Department of Thoracic Surgery of Wuhan Medical Treatment Center between October 2010 and October 2013.
All the 29 surgeries by VATS were successfully completed. No death case was reported. Operative duration of VATS was 75~400 min, with an average of 185.4 min; intraoperative amount of bleeding ranged 50 to 2300 ml, with an average of 575.6 ml; the incidence of postoperative complication was 21.4% (6/28). Postoperative complications occurred in 6 cases, among which there were 2 cases of persistent postoperative pulmonary air leak, 2 cases of pleural effusion, one case of thoracic hemorrhage and one case of arrhythmia complicated with left heart failure. There was one patient who was converted from VATS to open thoracic surgery half-way.
Our results have shown the efficacy, safety and a breakthrough in the "technical contraindications" of VATS in the management of TDL.
叶间裂不完整和胸膜粘连在结核毁损肺（TDL）中较为常见，属于电视辅助胸腔镜手术（VATS）的“技术禁忌证”。VATS治疗TDL的有效性和安全性尚未见详细报道。
本研究旨在观察VATS治疗TDL的有效性和安全性。
回顾性分析2010年10月至2013年10月在武汉市医疗救治中心胸外科行VATS解剖性肺叶切除术的29例TDL患者的临床资料。
29例VATS手术均顺利完成，无死亡病例。VATS手术时间为75～400分钟，平均185.4分钟；术中出血量为50～2300毫升，平均575.6毫升；术后并发症发生率为21.4%（6/28）。术后并发症6例，其中术后持续性肺漏气2例，胸腔积液2例，胸内出血1例，心律失常合并左心衰竭1例。有1例患者术中由VATS中转开胸手术。
本研究结果显示VATS治疗TDL具有有效性、安全性，并在“技术禁忌证”方面取得了突破。
