Porcel José M, Lee Pyng
Pleural Medicine Unit, Department of Internal Medicine, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain.
Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré, IRBLleida, 25198 Lleida, Spain.
J Clin Med. 2021 Aug 26;10(17):3835. doi: 10.3390/jcm10173835.
Video-assisted thoracic surgery (VATS) is the treatment of choice for recurrence prevention in patients with spontaneous pneumothorax (SP). Although the optimal surgical technique is uncertain, bullous resection using staplers in combination with mechanical pleurodesis, chemical pleurodesis and/or staple line coverage is usually undertaken. Currently, patient satisfaction, postoperative pain and other perioperative parameters have significantly improved with advancements in thoracoscopic technology, which include uniportal, needlescopic and nonintubated VATS variants. Ipsilateral recurrences after VATS occur in less than 5% of patients, in which case a redo-VATS is a feasible therapeutical option. Randomized controlled trials are urgently needed to shed light on the best definitive management of SP.
电视辅助胸腔镜手术(VATS)是预防自发性气胸(SP)患者复发的首选治疗方法。尽管最佳手术技术尚不确定,但通常采用吻合器进行肺大疱切除术,并结合机械胸膜固定术、化学胸膜固定术和/或吻合器缝线覆盖术。目前,随着胸腔镜技术的进步,包括单孔、针式和非插管VATS变体,患者满意度、术后疼痛和其他围手术期参数都有了显著改善。VATS术后同侧复发率不到5%,在这种情况下,再次VATS是一种可行的治疗选择。迫切需要进行随机对照试验,以阐明SP的最佳最终治疗方法。