Department of Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Department of Cardiovascular Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Gen Thorac Cardiovasc Surg. 2022 Mar;70(3):257-264. doi: 10.1007/s11748-021-01716-z. Epub 2021 Nov 1.
The induction of artificial pneumothorax has many intraoperative advantages. However, few reports on the postoperative effects of artificial pneumothorax induction are available. In this study, we investigated the effect of artificial pneumothorax on postoperative clinical course in patients with mediastinal tumors.
We retrospectively investigated the clinical courses of 89 patients who had undergone mediastinal tumor resection between January 2010 and December 2020. Sixty-five patients had undergone resection with artificial pneumothorax.
The tumor location significantly varied across patients. The proportion of patients in whom artificial pneumothorax was induced was higher among those having anterior mediastinal tumors. The number of ports and the total skin incision length were significantly higher in patients without artificial pneumothorax. The C-reactive protein level elevation on postoperative day 2 and pleural effusion at 24 h after surgery were significantly higher in patients without artificial pneumothorax. Furthermore, the albumin level reduction and hospital stay after surgery were significantly lower in patients with artificial pneumothorax. Multiple regression analysis showed that the use of artificial pneumothorax was an independent predictive factor of the C-reactive protein level elevation on postoperative day 2 and pleural effusion at 24 h after surgery. In patients without artificial pneumothorax, the operation time positively correlated with the C-reactive protein level (r = 0.646, P < 0.001).
Artificial pneumothorax suppressed the postoperative inflammatory response, pleural effusion, and albumin reduction, and shortened the hospital stay in patients undergoing mediastinal tumor surgery.
人工气胸的诱导具有许多术中优势。然而，关于人工气胸诱导术后效果的报道较少。本研究调查了人工气胸对纵隔肿瘤患者术后临床过程的影响。
我们回顾性调查了 2010 年 1 月至 2020 年 12 月期间接受纵隔肿瘤切除术的 89 例患者的临床过程。65 例患者接受了人工气胸切除术。
肿瘤位置在患者之间差异显著。在前纵隔肿瘤患者中，诱导人工气胸的患者比例较高。无人工气胸的患者端口数量和总皮肤切口长度明显较高。无人工气胸的患者术后第 2 天 C 反应蛋白水平升高和术后 24 小时胸腔积液的发生率明显较高。此外，人工气胸患者的白蛋白水平降低和术后住院时间明显较低。多因素回归分析表明，使用人工气胸是术后第 2 天 C 反应蛋白水平升高和术后 24 小时胸腔积液的独立预测因素。在无人工气胸的患者中，手术时间与 C 反应蛋白水平呈正相关（r=0.646，P<0.001）。
人工气胸抑制了纵隔肿瘤手术患者的术后炎症反应、胸腔积液和白蛋白减少，并缩短了住院时间。
