Dadaş Erdoğan, Özkan Berker, Sabuncu Timuçin, Tanju Serhan, Toker Alper, Dilege Şükrü
Department of Chest Surgery, Adıyaman University Faculty of Medicine, Adıyaman, Turkey.
Department of Chest Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Turk Thorac J. 2015 Jan;16(1):22-27. doi: 10.5152/ttd.2014.4475. Epub 2015 Jan 1.
Published experiences with thoracoscopic apical or total pleurectomy for patients with a pneumothorax are limited. We aimed to evaluate the long-term results and effectiveness of pleurectomy in our patients, that vast majority of whom underwent thoracoscopic apical or total pleurectomy.
Between January 2001 and December 2010, in the Istanbul University Medical School Department of Thoracic Surgery, 67 patients, consisting of 52 patients with a primary spontaneous pneumothorax and 15 with a secondary spontaneous pneumothorax who underwent 72 processes of thoracoscopic resection of blebs or bullae and pleural symphysis, consisting of 43% total pleurectomy, 42% apical pleurectomy plus pleural abrasion, and 15% non-pleurectomy pleurodesis procedures due to prolonged air leak or recurrent spontaneous pneumothorax, were analyzed retrospectively. The applied pleural procedures were: 1. total pleurectomy 2. apical pleurectomy and pleural abrasion for the remaining parts and 3. non-pleurectomy pleurodesis procedures. The long-term outcomes of patients undergoing the three different pleural procedures were compared.
Total pleurectomy process, apical pleurectomy and abrasion process for remaining parietal pleura, and non-pleurectomy pleurodesis procedures were performed 31, 30, and 11 times, respectively. No recurrence was observed in the total pleurectomy group, 1 recurrence was observed for the apical pleurectomy plus pleural abrasion group, and 2 recurrences were observed for the non-pleurectomy group.
Video-assisted thoracoscopic pleurectomy is a safe and effective method in spontaneous pneumothorax surgery. Especially, total pleurectomy has efficient results in the prevention of recurrences.
关于胸腔镜下对气胸患者进行顶部胸膜切除术或全胸膜切除术的已发表经验有限。我们旨在评估胸膜切除术在我们患者中的长期结果和有效性，我们的患者绝大多数接受了胸腔镜下顶部胸膜切除术或全胸膜切除术。
2001年1月至2010年12月期间，在伊斯坦布尔大学医学院胸外科，对67例患者进行了回顾性分析，其中包括52例原发性自发性气胸患者和15例继发性自发性气胸患者，他们接受了72次胸腔镜下肺大疱或肺气囊切除术及胸膜固定术，包括43%的全胸膜切除术、42%的顶部胸膜切除术加胸膜摩擦术，以及15%因持续漏气或复发性自发性气胸而进行的非胸膜切除术胸膜固定术。所应用的胸膜手术包括：1. 全胸膜切除术；2. 顶部胸膜切除术及对其余部分进行胸膜摩擦术；3. 非胸膜切除术胸膜固定术。比较了接受这三种不同胸膜手术的患者的长期结果。
全胸膜切除术、顶部胸膜切除术及对剩余壁层胸膜进行摩擦术、非胸膜切除术胸膜固定术分别进行了31次、30次和11次。全胸膜切除术组未观察到复发，顶部胸膜切除术加胸膜摩擦术组观察到1例复发，非胸膜切除术组观察到2例复发。
电视辅助胸腔镜胸膜切除术在自发性气胸手术中是一种安全有效的方法。特别是，全胸膜切除术在预防复发方面有显著效果。
