Sano Atsushi, Yotsumoto Takuma
Department of Thoracic Surgery, Chigasaki Municipal Hospital, Chigasaki, Kanagawa, Japan.
Ann Thorac Cardiovasc Surg. 2017 Oct 20;23(5):223-226. doi: 10.5761/atcs.oa.17-00054. Epub 2017 Jul 5.
We investigated the outcomes of surgery for pneumothorax following outpatient drainage therapy.
We reviewed the records of 34 patients who underwent operations following outpatient drainage therapy with the Thoracic Vent at our hospital between December 2012 and September 2016. Indications for outpatient drainage therapy were pneumothorax without circulatory or respiratory failure and pleural effusion. Indications for surgical treatment were persistent air leakage and patient preference for surgery to prevent or reduce the incidence of recurrent pneumothorax.
Intraoperatively, 9 of 34 cases showed loose adhesions around the Thoracic Vent, all of which were dissected bluntly. The preoperative drainage duration ranged from 5 to 13 days in patients with adhesions and from 3 to 19 days in those without adhesions, indicating no significant difference. The duration of preoperative drainage did not affect the incidence of adhesions. The operative duration ranged from 30 to 96 minutes in patients with adhesions and from 31 to 139 minutes in those without adhesions, also indicating no significant difference.
Outpatient drainage therapy with the Thoracic Vent was useful for spontaneous pneumothorax patients who underwent surgery, and drainage for less than 3 weeks did not affect intraoperative or postoperative outcomes.
我们调查了门诊引流治疗后气胸手术的结果。
我们回顾了2012年12月至2016年9月期间在我院接受胸式引流门诊治疗后接受手术的34例患者的记录。门诊引流治疗的指征为无循环或呼吸衰竭的气胸和胸腔积液。手术治疗的指征为持续漏气以及患者倾向于手术以预防或降低复发性气胸的发生率。
术中,34例中有9例在胸式引流周围显示粘连疏松,均予以钝性分离。有粘连患者术前引流时间为5至13天,无粘连患者为3至19天,差异无统计学意义。术前引流时间不影响粘连发生率。有粘连患者手术时间为30至96分钟,无粘连患者为31至139分钟,差异亦无统计学意义。
胸式引流门诊治疗对接受手术的自发性气胸患者有用,引流少于3周不影响术中或术后结果。