Nonomura Ryo, Tabata Toshiharu
Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan.
Kyobu Geka. 2021 Sep;74(10):833-838.
The decrease in the postoperative recurrence rate after thoracoscopic bullectomy for spontaneous pneumothorax is an issue that should be tackled even at this moment. We presently make sure to do the reinforcement of the visceral pleura around between the staple line on bullectomy and the common sites of the new-born bullae such as apex, top site of S6, interlobar fissure to prevent postoperative recurrence.
We evaluated the latest efficacy of preventing postoperative recurrence by widely covering the staple line and the common sites of the new-born bullae with a polyglycolic acid( PGA) sheet after bullectomy.
Retrospective analyses were performed for 1,097 patients with spontaneous pneumothorax who received thoracoscopic bullectomy at our hospital between January 2011 and December 2020. The 1-year, 3-years, 5-years postoperative recurrence rates of 229 patients with spontaneous pneumothorax were respectively calculated with the Kaplan-Meier method.
The 1-year, 3-years, 5-years postoperative recurrence rates of spontaneous pneumothorax were 0.9%, 3.6%, 4.0%, respectively.
Combination treatment with bullectomy and wide coverage of the staple line and the common sites of the new-born bullae with the PGA sheet reduced satisfyingly postoperative recurrence rates of spontaneous pneumothorax.
即便在当下，胸腔镜肺大疱切除术后复发率的降低仍是一个需要解决的问题。目前，我们确保在肺大疱切除术的缝合线与新生肺大疱的常见部位（如肺尖、S6顶点、叶间裂）之间对脏层胸膜进行加固，以防止术后复发。
我们评估了肺大疱切除术后用聚乙醇酸（PGA）片广泛覆盖缝合线和新生肺大疱的常见部位对预防术后复发的最新疗效。
对2011年1月至2020年12月期间在我院接受胸腔镜肺大疱切除术的1097例自发性气胸患者进行回顾性分析。采用Kaplan-Meier法分别计算229例自发性气胸患者术后1年、3年、5年的复发率。
自发性气胸术后1年、3年、5年的复发率分别为0.9%、3.6%、4.0%。
肺大疱切除术联合用PGA片广泛覆盖缝合线和新生肺大疱的常见部位，能令人满意地降低自发性气胸的术后复发率。
