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在一家三级胸外科中心接受电视辅助胸腔镜手术的支气管扩张症患者分析:十年经验

Analysis of bronchiectasis patients who underwent video-assisted thoracoscopic surgery in a tertiary thoracic surgery center: Ten years of experience.

作者信息

Aydoğdu Koray, Çetin Mehmet, Yılmaz Emre, Mustafa Demiröz Şevki, Türk İlteriş, İncekara Funda, Alagöz Ali, Fındık Göktürk

机构信息

Department of Thoracic Surgery, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Türkiye.

Department of Thoracic Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Apr 30;32(2):202-211. doi: 10.5606/tgkdc.dergisi.2024.25891. eCollection 2024 Apr.

Abstract

BACKGROUND

This study aimed to analyze our video-assisted thoracic surgery (VATS) experience in the surgical treatment of bronchiectasis and the reasons limiting VATS application.

METHODS

Two hundred one patients (106 males, 95 females; mean age: 39.7±14.1 years; range, 12 to 68 years) who underwent surgical treatment for bronchiectasis between January 2012 and October 2021 were included in the retrospective study. Three groups were created based on the surgical technique used: VATS, thoracotomy, and patients who were converted from VATS to thoracotomy.

RESULTS

The most significant presenting symptoms were cough (43%) and excessive sputum expectoration (40%). Surgical intervention was applied to the left side of 60% of the patients, and the most common resection performed in all three groups was left lower lobectomy. The rate of conversion from VATS to thoracotomy was 28.8%, and it was found that dense pleural adhesions were the most common reason. Revision surgery was performed on a total of 11 (5.47%) patients. The frequency of revision surgery did not differ significantly among the three groups (p=0.943). The most common postoperative complication was prolonged air leakage. There was no statistically significant difference in postoperative complication rates among the groups (p=0.417). The rate of surgical treatment of bronchiectasis with VATS was observed to have increased from 11.1% to 77.7% in our clinic.

CONCLUSION

In experienced hands, VATS can be safely applied in the surgical treatment of bronchiectasis.

摘要

背景

本研究旨在分析我们在支气管扩张症外科治疗中的电视辅助胸腔镜手术(VATS)经验以及限制VATS应用的原因。

方法

回顾性研究纳入了2012年1月至2021年10月间接受支气管扩张症手术治疗的201例患者(男性106例,女性95例;平均年龄:39.7±14.1岁;范围12至68岁)。根据所采用的手术技术分为三组:VATS组、开胸手术组以及由VATS转为开胸手术的患者组。

结果

最主要的表现症状是咳嗽(43%)和咳痰过多(40%)。60%的患者手术干预应用于左侧,所有三组中最常见的切除手术是左下叶切除术。VATS转为开胸手术的比例为28.8%,发现致密的胸膜粘连是最常见的原因。共有11例(5.47%)患者进行了再次手术。三组之间再次手术的频率差异无统计学意义(p = 0.943)。最常见的术后并发症是持续漏气。各组术后并发症发生率差异无统计学意义(p = 0.417)。在我们的诊所,观察到支气管扩张症VATS手术治疗率从11.1%增加到了77.7%。

结论

在经验丰富的医生手中,VATS可安全应用于支气管扩张症的外科治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/210f/11197415/cd9feed6a416/TJTCS-2024-32-2-202-211-F1.jpg

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