Inoue N, Yamada A, Koshino T
Department of Thoracic and Cardiovascular Surgery, Sapporo General Hospital of Hokkaido Railway Company, Japan.
Kyobu Geka. 1998 Jun;51(6):481-5.
Between April 1992 and March 1997, 32 patients with primary spontaneous pneumothorax were operated in our institution. In the first three years, 9 patients underwent thoracotomy which was classified into two groups axillary thoracotomy group (AX group) in 5 cases and postero-lateral thoracotomy group (PL group) in 4 cases. In the recent two years, 23 consecutive patients underwent video-assisted thoracoscopic surgery (VATS group). The operating time, intraoperative blood loss, serum CRP and CK level, the duration of the indwelling chest tube, postoperative hospital stay, the duration of epidural anesthesia, complications and recurrences were compared among the three groups. The CRP level was significantly lower in VATS group than in both AX group and PL group. The duration of indwelling chest tube and postoperative hospital stay were significantly less in VATS group than in both AX group and PL group. There was no significant difference in complications and recurrences among the three groups We conclude from findings that VATS is superior to thoracotomy in the treatment of primary spontaneous pneumothorax. However more careful intraoperative manipulation is required to prevent postoperative recurrence.
1992年4月至1997年3月期间，我院对32例原发性自发性气胸患者进行了手术治疗。在最初的三年里，9例患者接受了开胸手术，其中5例为腋下开胸组（AX组），4例为后外侧开胸组（PL组）。在最近两年里，23例连续患者接受了电视辅助胸腔镜手术（VATS组）。比较了三组患者的手术时间、术中出血量、血清CRP和CK水平、胸腔闭式引流管留置时间、术后住院时间、硬膜外麻醉时间、并发症和复发情况。VATS组的CRP水平显著低于AX组和PL组。VATS组的胸腔闭式引流管留置时间和术后住院时间显著短于AX组和PL组。三组患者在并发症和复发方面无显著差异。我们从研究结果得出结论，在原发性自发性气胸的治疗中，VATS优于开胸手术。然而，需要更仔细的术中操作以防止术后复发。
