Fujita Tomohiro, Matsumoto Takamune, Morino Shigeyuki, Nakamura Akihiro
Department of Thoracic Surgery, Sasebo City General Hospital, Sasebo, Japan.
Kyobu Geka. 2020 Nov;73(12):1002-1005.
Extrapleural hematoma caused by thoracic vertebral burst fracture is very rare. We present the case of a 70-year-old man who was treated with a combination of video-assisted thoracic surgery (VATS) and extrathoracic operation. The patient was admitted to our hospital with complaints of dyspnea and pain in both legs. Computed tomography (CT) demonstrated a massive extrapleural hematoma in the right thoracic cavity, and 12th thoracic vertebral burst fracture. We treated the patient with pharmacotherapy because CT showed no active bleeding and the circulation and respiratory dynamics were stable. One week later, the hematoma was not reduced by pharmacotherapy, so we performed combination surgery of VATS. After surgery, there were no serious complications and the patient was discharged from the hospital on day 11 from surgery. In the following 2 months, there was no evidence of recurrence. The combination of VATS and extrathoracic operation was safe, and good result was obtained.
胸椎爆裂性骨折引起的胸膜外血肿非常罕见。我们报告了一例70岁男性患者，采用电视辅助胸腔镜手术（VATS）和胸外手术联合治疗。该患者因呼吸困难和双腿疼痛入院。计算机断层扫描（CT）显示右侧胸腔有巨大的胸膜外血肿，以及第12胸椎爆裂性骨折。由于CT显示无活动性出血且循环和呼吸动力学稳定，我们对患者进行了药物治疗。一周后，药物治疗未能使血肿缩小，因此我们进行了VATS联合手术。术后无严重并发症，患者于术后第11天出院。在接下来的2个月里，没有复发的迹象。VATS和胸外手术联合治疗是安全的，并且取得了良好的效果。
