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单孔胸腔镜治疗肺包虫囊肿:初步结果

Uniportal Thoracoscopic Approach For Pulmonary Hydatid Cyst: Preliminary Results.

作者信息

Ocakcioglu Ilhan, Sayir Fuat

机构信息

Department of Thoracic Surgery, Marmara University Pendik Training and Research Hospital, Istanbul.

Department of Thoracic Surgery, Medicine Faculty of Yüzüncü Yil University, Van, Turkey.

出版信息

Surg Laparosc Endosc Percutan Tech. 2018 Oct;28(5):298-302. doi: 10.1097/SLE.0000000000000560.

Abstract

PURPOSE

Pulmonary hydatid cyst is a preventable parasitary disease with high prevalence in low-medium income countries. Thoracoscopic approach is seen in the literature as small-case groups and multiple-port incisions are observed in these studies. Unlike other thoracoscopic approaches for the surgical treatment, we describe the single-port technique for the first time in our study. We attempt to compare the clinical outcomes and preliminary results of patients with pulmonary hydatid cyst treated with either minimally invasive or thoracotomy.

METHODS

The medical records of 66 patients undergoing surgery for pulmonary hydatid cyst disease between January 2013 and July 2017 were reviewed. The number of patients who underwent thoracotomy was 48, whereas 18 were managed by single-port video-assisted thoracoscopic surgery. Variables statistically compared between the 2 groups were age, diameter of the cystic, operation time, volume and duration of the drainage, postoperative complications, length of stay, duration of narcotic analgesic usage, and pain score.

RESULTS

Thoracoscopic approach was superior to conventional thoracotomy in terms of operation time, drainage volume, time to drain removal, hospital stay, narcotic analgesic treatment duration, and postoperative pain scores. All thoracoscopic procedures were concluded successfully, and conversion to open surgery was not required. No postoperative mortality was seen in either group. During the follow-up period, no recurrence was encountered in either group.

CONCLUSIONS

Uniportal thoracoscopic approach is a safe option for the treatment of hydatid cyst disease. It can be used as an alternative to thoracotomy, depending on the size and location of the lesion.

摘要

目的

肺包虫囊肿是一种在中低收入国家高发的可预防寄生虫病。在文献中,胸腔镜手术多见于小病例组,且这些研究中观察到的是多端口切口。与其他用于手术治疗的胸腔镜方法不同,我们在研究中首次描述了单端口技术。我们试图比较采用微创或开胸手术治疗的肺包虫囊肿患者的临床结局和初步结果。

方法

回顾了2013年1月至2017年7月期间66例接受肺包虫囊肿病手术患者的病历。接受开胸手术的患者有48例,而18例采用单端口电视辅助胸腔镜手术治疗。两组间进行统计学比较的变量包括年龄、囊肿直径、手术时间、引流量和引流持续时间、术后并发症、住院时间、麻醉性镇痛药使用持续时间和疼痛评分。

结果

在手术时间、引流量、拔管时间、住院时间、麻醉性镇痛药治疗持续时间和术后疼痛评分方面,胸腔镜手术方法优于传统开胸手术。所有胸腔镜手术均成功完成,无需转为开放手术。两组均未出现术后死亡。在随访期间,两组均未出现复发。

结论

单孔胸腔镜手术是治疗包虫囊肿病的一种安全选择。根据病变的大小和位置,它可作为开胸手术的替代方法。

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