Atta H M, Latouf O, Moore J E, Caudill D R, Snyder A B
Georgia Baptist Medical Center, Atlanta, USA.
Am Surg. 1997 Mar;63(3):209-12.
We reviewed our experience with thoracotomy (TH) and video-assisted thoracoscopic pleurectomy (VAT) for the treatment of recurrent spontaneous pneumothorax. Nine patients underwent 10 VATs. One patient had bilateral procedures 1 week apart. Nine patients underwent 10 THs. One patient had bilateral TH at the same session. The mean duration of postoperative hospital stay for VAT and TH was 5.7 days and 6.4, respectively. VAT operative time was longer (128 vs 93.6 min in the TH group); however, the estimated blood loss was larger in the TH group (136 vs 108.3 ml in the VAT group). There were no deaths in either group. In the VAT group, one patient had recurrence of pneumothorax 1 month after surgery. In the TH group, there was no recurrence of pneumothorax, but one patient had chronic pain at the site of the thoracotomy incision. One patient was lost to follow-up in each group. We conclude that VAT is a safe and reasonably effective treatment of spontaneous pneumothorax. However, large series with long-term follow-up are needed to place this procedure in its proper perspective.
我们回顾了开胸手术（TH）和电视辅助胸腔镜胸膜切除术（VAT）治疗复发性自发性气胸的经验。9例患者接受了10次VAT手术。1例患者在相隔1周的时间内接受了双侧手术。9例患者接受了10次TH手术。1例患者在同一次手术中接受了双侧TH手术。VAT和TH术后平均住院时间分别为5.7天和6.4天。VAT手术时间更长（VAT组为128分钟，TH组为93.6分钟）；然而，TH组估计失血量更大（TH组为136毫升，VAT组为108.3毫升）。两组均无死亡病例。VAT组有1例患者术后1个月气胸复发。TH组无气胸复发，但有1例患者开胸切口部位出现慢性疼痛。每组各有1例患者失访。我们得出结论，VAT是治疗自发性气胸的一种安全且相当有效的方法。然而，需要进行大量长期随访的系列研究才能正确看待该手术。
