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完全胸腔镜辅助肋骨骨折手术:35 例系列报告。

Complete Video-assisted Thoracoscopic Surgery for Rib Fractures: Series of 35 Cases.

机构信息

Department of Cardiothoracic Surgery, Shenzhen Longgang Central Hospital, the Ninth People's Hospital of Shenzhen City, Shenzhen, China.

Department of Cardiothoracic Surgery, Shenzhen Longgang Central Hospital, the Ninth People's Hospital of Shenzhen City, Shenzhen, China.

出版信息

Ann Thorac Surg. 2022 Feb;113(2):452-458. doi: 10.1016/j.athoracsur.2021.01.065. Epub 2021 Mar 3.

DOI:10.1016/j.athoracsur.2021.01.065
PMID:33675706
Abstract

BACKGROUND

Video-assisted thoracoscopic surgery (VATS) for internal fixation of rib fractures is a promising approach for treating rib fractures and flail chest. Currently the standard practice is to make 1 or several incisions on the chest wall, which will inevitably aggravate the original trauma.

METHODS

We retrospectively analyzed the data of patients with rib fractures who were treated with memory alloy for internal fixation by complete VATS using a thoracoscopic transthoracic memory alloy rib coaptation board and an implantation tool through the clip applier method or the puncture, traction, and suspension method at our hospital from October 2016 to June 2019.

RESULTS

Of 35 patients, 12 had traumatic flail chest injury and 23 had simple multiple rib fractures. Of the 23 patients with multiple rib fractures, 9 had fracture ends in the scapular or paravertebral region and 14 in the anterior or lateral chest walls. All surgeries were performed with complete VATS, which showed quick recovery and good thoracic appearance and function, with no complications for all patients. Follow-up for 6 to 24 months revealed no detachment of the internal fixation device.

CONCLUSIONS

Internal memory alloy fixation with complete VATS for the treatment of rib fractures is a simple and minimally invasive method that enables fixing fractured ribs internally while treating thoracic trauma with a thoracoscope.

摘要

背景

胸腔镜辅助下肋骨内固定术(VATS)治疗肋骨骨折和连枷胸具有广阔的应用前景。目前的标准做法是在胸壁上做 1 个或多个切口,这不可避免地会加重原有创伤。

方法

我们回顾性分析了我院 2016 年 10 月至 2019 年 6 月采用胸腔镜经胸记忆合金肋骨吻合板和植入器械,通过夹合器或穿刺、牵引、悬吊法,完全 VATS 治疗肋骨骨折患者的资料。

结果

35 例患者中,12 例为创伤性连枷胸损伤,23 例为单纯多发性肋骨骨折。23 例多发性肋骨骨折中,9 例骨折端位于肩胛或椎旁区,14 例位于前或侧胸壁。所有手术均采用完全 VATS 完成,患者均快速康复,胸廓外观和功能良好,无并发症。随访 6 至 24 个月,未见内固定装置脱落。

结论

完全 VATS 下内置记忆合金固定治疗肋骨骨折是一种简单微创的方法,可通过胸腔镜治疗胸外伤的同时对内固定骨折肋骨。

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