Freixinet J, Canalis E, Rivas J J, Rodriguez de Castro F, Torres J, Gimferrer J M, Sanchez-Lloret J
Thoracic Surgery Service, University Hospital Ntra. Sra. del Pino, Canary Island, Spain.
Eur Respir J. 1997 Feb;10(2):409-11. doi: 10.1183/09031936.97.10020409.
We report the results of our experience using video-assisted thoracoscopic surgery (VATS) to treat primary spontaneous pneumothorax (PSP) from January 1992 until December 1994 in a multicentered co-operative study. A total of 132 patients (110 males and 22 females, aged 13-38 yrs, mean age 26 yrs) were treated by VATS to deal with the PSP that they presented with. A standard VATS technique was used. Apical bullae were always removed, and mechanical pleural abrasion was performed, leaving a pleural drainage tube. In two cases (1.5%), a switch to thoracotomy was necessary. In eight cases (6%), air leakage persisted for 5 days after surgery, which resolved with pleural drainage. There were eight postoperative relapses (6%), which were treated with pleural drainage (n = 4), VATS (n = 3) or axillar thoracotomy (n = 1). The average postoperative stay was 5.6 days (range 2-15 days). We conclude that video-assisted thoracoscopic surgery is a viable alternative for the treatment of primary spontaneous pneumothorax. There is, however, a high relapse rate, and in a number of cases air leakage persists in the postoperative period.
我们报告了在一项多中心合作研究中，1992年1月至1994年12月期间使用电视辅助胸腔镜手术（VATS）治疗原发性自发性气胸（PSP）的经验结果。共有132例患者（110例男性，22例女性，年龄13 - 38岁，平均年龄26岁）接受了VATS治疗以处理其所患的PSP。采用标准的VATS技术。总是切除顶端肺大疱，并进行机械性胸膜摩擦，留置一根胸腔引流管。有2例（1.5%）需要转为开胸手术。8例（6%）术后漏气持续5天，经胸腔引流后缓解。有8例（6%）术后复发，分别采用胸腔引流（n = 4）、VATS（n = 3）或腋下开胸手术（n = 1）进行治疗。术后平均住院时间为5.6天（范围2 - 15天）。我们得出结论，电视辅助胸腔镜手术是治疗原发性自发性气胸的一种可行替代方法。然而，复发率较高，并且在许多病例中术后漏气会持续存在。
