Bishnoi Sukhram, Puri Harsh Vardhan, Asaf Belal Bin, Pulle Mohan Venkatesh, Parikh Manan Bharat Kumar, Patel Mitul Vinodbhai, Sirohi Ajay, Kumar Arvind
Centre for Chest Surgery, Sir Ganga Ram Hospital, New Delhi, India.
J Minim Access Surg. 2022 Apr-Jun;18(2):230-234. doi: 10.4103/jmas.JMAS_251_20.
This study aims at describing the feasibility and safety of video-assisted thoracic surgery (VATS) in benign diseases such as pulmonary sequestrations (PSs) and report the surgical outcomes.
This is a retrospective analysis of prospectively maintained data of 25 patients who were operated for PS over 7 years at a dedicated thoracic surgery centre in India. Pre-operative details, operative technique and details, post-operative details and complications were recorded and analysed.
There were 15 (60%) males and 10 (40%) females, with a median age of 22.28 years (range, 16-28 years). All patients had intra-lobar type of sequestration. The most commonly involved was left lower lobe (n = 15 patients, 60%) followed by the right lower lobe (n = 10 patients, 40%). The origin of blood supply was from the descending thoracic aorta in 18 patients (72%), the abdominal aorta in 5 (20%) and the coeliac trunk and the inferior phrenic artery in one patient (4%) each. All patients underwent complete lobar resection. One patient was converted because of dense hilar adhesion. The average duration of surgery was 179 min and the average blood loss was 204 ml. The median hospital stay and chest tube duration were 4 and 3 days, respectively. One patient was re-explored because of post-operative bleeding. Only one patient had an air leak for >7 days. The median follow-up was 42 months (range, 6-90 months) without any recurrence.
VATS is a safe, feasible and effective option for PS at experienced centres.
本研究旨在描述电视辅助胸腔镜手术(VATS)治疗诸如肺隔离症(PSs)等良性疾病的可行性和安全性,并报告手术结果。
这是一项对印度一家专门的胸外科中心7年间接受PS手术的25例患者的前瞻性维护数据进行的回顾性分析。记录并分析术前细节、手术技术及细节、术后细节和并发症。
男性15例(60%),女性10例(40%),中位年龄22.28岁(范围16 - 28岁)。所有患者均为叶内型隔离症。最常受累的是左下叶(15例患者,60%),其次是右下叶(10例患者,40%)。供血来源为胸降主动脉的有18例患者(72%),腹主动脉的有5例(20%),腹腔干和膈下动脉各有1例患者(4%)。所有患者均接受了完整的肺叶切除术。1例患者因肺门致密粘连而中转开胸。平均手术时长为179分钟,平均失血量为204毫升。中位住院时间和胸管留置时间分别为4天和3天。1例患者因术后出血接受了再次手术探查。只有1例患者漏气超过7天。中位随访时间为42个月(范围6 - 90个月),无任何复发。
在经验丰富的中心,VATS是治疗PS的一种安全、可行且有效的选择。