Urschel J D, Dickout W J
Thoracic Diseases Unit, Misericordia Hospital, Edmonton, Alta.
Can J Surg. 1993 Dec;36(6):548-50.
Most patients with spontaneous pneumothorax secondary to bullous emphysema are successfully managed by chest-tube drainage. Occasionally a very large air leak prevents full lung expansion. The authors report on a patient in whom thoracoscopic intracavitary drainage of a leaking bulla led to rapid resolution of the pneumothorax and obliteration of the bulla. A large bronchopleural fistula was converted to a controlled bronchocutaneous fistula. The authors conclude that when conventional management fails to provide full lung expansion in cases of pneumothorax secondary to bullous emphysema, thoracoscopic intracavitary drainage is useful.
大多数继发于大疱性肺气肿的自发性气胸患者通过胸腔闭式引流可成功治愈。偶尔会出现非常大的漏气，导致肺无法完全复张。作者报道了1例患者，通过胸腔镜对漏气的肺大疱进行腔内引流，使气胸迅速缓解，肺大疱消失。一个大的支气管胸膜瘘转变为可控的支气管皮肤瘘。作者得出结论，在继发于大疱性肺气肿的气胸患者中，当传统治疗方法无法使肺完全复张时，胸腔镜腔内引流是有效的。
