Doğusoy Ilgaz, Yıldırım Mehmet, Ustaalioğlu Recep, Demirbağ Hatice
Acıbadem Mehmet Ali Aydınlar University, Vocational School of Health Services, Operating Room Services, İstanbul, Turkey.
Department of Thoracic Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Jan 9;26(1):132-137. doi: 10.5606/tgkdc.dergisi.2018.15279. eCollection 2018 Jan.
This study aims to compare the results of video-assisted thoracoscopic surgery and axillary thoracotomy in the surgical treatment of primary spontaneous pneumothorax.
Between January 2009 and December 2015, a total of 199 patients (178 males, 21 females; mean age 21.3±7.1 years; range 13 to 35 years) with primary spontaneous pneumothorax who were operated at Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Thoracic Surgery and Kadikoy and Kozyatagi Acibadem hospitals were retrospectively analyzed. Of these patients, 48 underwent axillary thoracotomy, wedge resection, apical pleurectomy, and tissue adhesives, while 151 were administered videoassisted thoracoscopic surgery, wedge resection, apical pleurectomy, and tissue adhesives. Both groups were compared in terms of age, gender, the amount of long-term analgesic use, duration of surgery, length of hospitalization, recurrence, complication, and mortality rates.
The patients were followed for one year. No mortality was observed in any patient. There was no significant difference in the age and gender distributions of the patients, postoperative length of hospital stay, recurrence rates, and complication rates according to the type of operation. However, the duration of operation was longer in the videoassisted thoracoscopic surgery patients.
Video-assisted thoracoscopic surgery is associated with less pain and higher patient satisfaction and allows returning to daily activities in a shorter time period. Based on our study results, we suggest that video-assisted thoracoscopic surgery is more suitable, compared to axillary thoracotomy, owing to its advantages, such as being less invasive and providing a better angle of view.
本研究旨在比较电视辅助胸腔镜手术与腋下开胸手术治疗原发性自发性气胸的效果。
回顾性分析2009年1月至2015年12月期间在锡亚米·埃尔塞克胸心血管外科培训与研究医院胸外科、卡迪科伊和科兹亚塔吉阿西巴德姆医院接受手术的199例原发性自发性气胸患者(178例男性,21例女性;平均年龄21.3±7.1岁;年龄范围13至35岁)。其中,48例行腋下开胸手术、楔形切除术、胸膜顶切除术及使用组织黏合剂,151例行电视辅助胸腔镜手术、楔形切除术、胸膜顶切除术及使用组织黏合剂。比较两组患者的年龄、性别、长期镇痛药物使用量、手术时长、住院时间、复发率、并发症及死亡率。
对患者进行了为期一年的随访。所有患者均未观察到死亡情况。根据手术类型,患者的年龄和性别分布、术后住院时间、复发率及并发症发生率无显著差异。然而,电视辅助胸腔镜手术患者的手术时间更长。
电视辅助胸腔镜手术疼痛较轻,患者满意度较高,能使患者在更短时间内恢复日常活动。基于我们的研究结果,我们认为与腋下开胸手术相比,电视辅助胸腔镜手术因其具有创伤小、视野角度更好等优点而更适用。