Department of Thoracic Surgery, Yeni Yuzyil University School of Medicine Gaziosmanpasa Hospital, Istanbul, Turkey.
Department of Thoracic Surgery, University of Health Sciences Kartal Kosuyolu Yuksek Ihtisas Hospital, Istanbul, Turkey.
Braz J Cardiovasc Surg. 2021 Dec 3;36(6):760-768. doi: 10.21470/1678-9741-2020-0299.
The aim of this study was to evaluate the delayed chest closure (DCC) results in patients who underwent lung transplantation.
Sixty patients were evaluated retrospectively. Only bilateral lung transplantations and DCC for oversized lung allograft (OLA) were included in the study. Six patients who underwent single lung transplantation, four patients who underwent lobar transplantation, two patients who underwent retransplantation, and four patients who underwent DCC due to bleeding risk were excluded from the study. Forty-four patients were divided into groups as primary chest closure (PCC) (n=28) and DCC (n=16). Demographics, donor characteristics, and operative features and outcomes of the patients were compared.
The mean age was 44.5 years. There was no significant difference between the demographics of the groups (P>0.05). The donor/recipient predicted total lung capacity ratio was significantly higher in the DCC group than in the PCC group (1.06 vs. 0.96, P=0.008). Extubation time (4.3 vs. 3.1 days, P=0.002) and intensive care unit length of stay (7.6 vs. 5.2 days, P=0.016) were significantly higher in the DCC group than in the PCC group. In the DCC group, postoperative wound infection was significantly higher than in the PCC group (18.6% vs. 0%, P=0.19). Median survival was 14 months in all patients and there was no significant difference in survival between the groups (16 vs. 13 months, P=0.300).
DCC is a safe and effective method for the management of OLA in lung transplantation.
本研究旨在评估肺移植患者行延迟性胸廓关闭术（DCC）的结果。
回顾性评估了 60 例患者。本研究仅纳入了双侧肺移植和超大供肺（OLA）行 DCC 的患者。排除了 6 例单肺移植、4 例肺叶移植、2 例再次移植以及 4 例因出血风险而行 DCC 的患者。44 例患者被分为行初次胸廓关闭术（PCC）（n=28）和 DCC（n=16）的两组。比较了两组患者的人口统计学、供体特征、手术特点和结果。
患者的平均年龄为 44.5 岁。两组患者的人口统计学特征无显著差异（P＞0.05）。DCC 组的供体/受者预计总肺容量比显著高于 PCC 组（1.06 比 0.96，P=0.008）。DCC 组的拔管时间（4.3 天比 3.1 天，P=0.002）和重症监护病房住院时间（7.6 天比 5.2 天，P=0.016）均显著长于 PCC 组。DCC 组术后伤口感染的发生率显著高于 PCC 组（18.6%比 0%，P=0.19）。所有患者的中位生存时间为 14 个月，两组间的生存无显著差异（16 个月比 13 个月，P=0.300）。
DCC 是肺移植中处理 OLA 的一种安全有效的方法。
