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肺切除术后和空气漏出后残余空间的处理:超声和气腹。

Management of residual spaces after lung resections and air leaks: Ultrasound and pneumoperitoneum.

机构信息

Thoracic Surgery Unit, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Campania, Italy.

Medical Oncology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.

出版信息

Interact Cardiovasc Thorac Surg. 2022 Jun 15;35(1). doi: 10.1093/icvts/ivac035.

Abstract

Prolonged chest tube drainage is one of the most common postoperative complications of pulmonary resections; it is related to complications such as residual pleural spaces or continuous alveolar air leaks. We retrospectively evaluated the efficacy of artificial intraoperative pneumoperitoneum in the treatment of such complications after lung resections. The presence of a residual space associated with prolonged air leaks can be difficult to treat, exposes the patient to a high risk of infection, prolongs hospitalization, and in some cases mandates reoperation. Between October 2016 and March 2020, four patients underwent pneumoperitoneum. The obliteration of the pleural cavity and the absence of air leaks were observed in 3 patients; only 1 patient was discharged with a Heimlich valve. Artificial intraoperative pneumoperitoneum is a safe and simple procedure. It decreases the duration of chest drainage and of the hospital stay; however, further studies are needed to corroborate our data. The learning curve for this technique may be relatively short.

摘要

长时间的胸腔引流是肺切除术后最常见的并发症之一;它与残留胸膜腔或持续肺泡漏气等并发症有关。我们回顾性评估了人工术中气腹在肺切除术后治疗此类并发症的疗效。与持续漏气相关的残余空间的存在可能难以治疗,使患者面临高感染风险,延长住院时间,在某些情况下需要再次手术。2016 年 10 月至 2020 年 3 月,4 名患者接受了气腹。3 名患者观察到胸腔腔隙闭塞且无漏气;只有 1 名患者出院时带有海姆利希阀。人工术中气腹是一种安全简单的操作。它缩短了胸腔引流和住院时间;然而,需要进一步的研究来证实我们的数据。该技术的学习曲线可能相对较短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58f9/9252113/652b037adc08/ivac035f1.jpg

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