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电视辅助胸腔镜手术对肋骨骨折进行微创外科固定的临床结果

Clinical Outcomes of Minimally Invasive Surgical Stabilization of Rib Fractures Using Video-Assisted Thoracoscopic Surgery.

作者信息

Bae Chae-Min, Son Shin-Ah, Lee Yong Jik, Lee Sang Cjeol

机构信息

Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

出版信息

J Chest Surg. 2023 Mar 5;56(2):120-125. doi: 10.5090/jcs.22.119. Epub 2023 Jan 30.

Abstract

BACKGROUND

Multiple rib fractures are common in blunt chest trauma. Until recently, most surgical rib fixations for multiple rib fractures were performed via open thoracotomy. However, due to the invasive nature of tissue dissection and the resulting large wound, an alternative endoscopic approach has emerged that minimizes the postoperative complications caused by the manipulation of injured tissue and lung during an open thoracotomy.

METHODS

Our study concentrated on patients with multiple rib fractures who underwent surgical stabilization of rib fractures (SSRF) between June 2018 and May 2020. We found 27 patients who underwent SSRF using video-assisted thoracoscopic surgery. The study design was a retrospective review of the patients' charts and surgical records.

RESULTS

No intraoperative events or procedure-related deaths occurred. Implant-related irritation occurred in 4 patients, and 1 death resulted from concomitant trauma. The average hospital stay was 30.2±20.1 days, and ventilators were used for 12 of the 22 patients admitted to the intensive care unit. None of the patients experienced major pulmonary complications such as pneumonia or acute respiratory distress syndrome.

CONCLUSION

Minimally invasive rib stabilization surgery with the assistance of a thoracoscope is expected to become more widely used in patients with multiple rib fractures. This method will also assist patients in a quick recovery.

摘要

背景

多发性肋骨骨折在钝性胸部创伤中很常见。直到最近,大多数多发性肋骨骨折的手术肋骨固定都是通过开胸手术进行的。然而,由于组织解剖的侵入性以及由此产生的大伤口,一种替代性的内镜方法出现了,这种方法能将开胸手术期间对受伤组织和肺部的操作所引起的术后并发症降至最低。

方法

我们的研究集中于2018年6月至2020年5月期间接受肋骨骨折手术固定(SSRF)的多发性肋骨骨折患者。我们找到了27例使用电视辅助胸腔镜手术进行SSRF的患者。研究设计是对患者病历和手术记录进行回顾性分析。

结果

未发生术中事件或与手术相关的死亡。4例患者出现植入物相关刺激,1例死亡由合并创伤导致。平均住院时间为30.2±20.1天,22例入住重症监护病房的患者中有12例使用了呼吸机。没有患者发生诸如肺炎或急性呼吸窘迫综合征等重大肺部并发症。

结论

胸腔镜辅助下的微创肋骨稳定手术有望在多发性肋骨骨折患者中得到更广泛的应用。这种方法也将有助于患者快速康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d7e/10008365/f1206b69232d/jcs-56-2-120-f1.jpg

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