Ocakcioglu Ilhan, Sayir Fuat
Department of Thoracic Surgery, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey.
Department of Thoracic Surgery, Medicine Faculty, Yüzüncü Yıl University, Van, Turkey.
Wideochir Inne Tech Maloinwazyjne. 2019 Jan;14(1):126-132. doi: 10.5114/wiitm.2018.77266. Epub 2018 Jul 24.
Despite the advantages and expanded indications of video-assisted thoracoscopic surgery, the open surgical approach is commonly preferred for the surgical treatment of rib lesions. Such an approach could lead to disadvantageous results such as increased postoperative pain and prolonged hospital stay. Despite all these handicaps, thoracoscopic resection of isolated rib resection has been reported in a small number of publications.
To compare the clinical outcomes of patients with isolated benign rib pathologies treated with either minimally invasive or open surgery.
The medical records of 22 patients undergoing surgery for isolated benign rib pathologies between 2013 and 2017 were reviewed. Variables statistically compared between the two groups were age, gender, symptoms, lesion size, duration of the surgery, amount of intraoperative bleeding, conversion to open surgery, volume and duration of the drainage, postoperative complications, length of hospital stay, pathological diagnosis, follow-up period, recurrence, duration of narcotic analgesic usage and pain according to visual analog scale evaluation.
The thoracoscopic approach was superior to conventional surgery in terms of drainage volume, time to drain removal, morbidity, hospital stay, narcotic analgesic treatment duration and postoperative pain scores. All thoracoscopic procedures were concluded successfully, and conversion to open surgery was not required. During the mean 14-month follow-up period, no recurrence was encountered in either group.
This technique is a safe option for isolated benign lesions of the ribs. It is more effective in patient recovery in the postoperative period and in the management of surgical pain.
尽管电视辅助胸腔镜手术具有诸多优势且适应证不断扩大，但对于肋骨病变的手术治疗，开放手术方法仍普遍更受青睐。这种方法可能会导致一些不利结果，如术后疼痛加剧和住院时间延长。尽管存在这些不利因素，但少数文献报道了胸腔镜下孤立性肋骨切除术。
比较采用微创或开放手术治疗孤立性良性肋骨病变患者的临床结局。
回顾了2013年至2017年间22例接受孤立性良性肋骨病变手术患者的病历。对两组进行统计学比较的变量包括年龄、性别、症状、病变大小、手术时长、术中出血量、转为开放手术的情况、引流量和引流时间、术后并发症、住院时间、病理诊断、随访期、复发情况、麻醉性镇痛药使用时长以及根据视觉模拟量表评估的疼痛程度。
胸腔镜手术在引流量、拔管时间、发病率、住院时间、麻醉性镇痛药治疗时长和术后疼痛评分方面优于传统手术。所有胸腔镜手术均成功完成，无需转为开放手术。在平均14个月的随访期内，两组均未出现复发。
该技术是治疗孤立性肋骨良性病变的一种安全选择。它在患者术后恢复和手术疼痛管理方面更有效。
