活体供肾输尿管切除术期间的胸膜切开术、气胸及监测
Pleurotomy, pneumothorax, and surveillance during living donor nephroureterectomy.
作者信息
Olsson L E, Swana H, Friedman A L, Lorber M I
机构信息
Department of Surgery, Yale-New Haven Hospital, Connecticut, USA.
出版信息
Urology. 1998 Oct;52(4):591-3. doi: 10.1016/s0090-4295(98)00227-1.
OBJECTIVES
To determine the incidence of and risk factors associated with pneumothorax after donor nephroureterectomy and to determine the utility of postoperative chest roentgenography.
METHODS
A retrospective review was made of 130 living donor nephroureterectomies performed at one institution (Yale-New Haven Hospital) using an extraperitoneal flank incision.
RESULTS
Incidental pleurotomy occurred in 11 cases (8.5%). Rib resection was associated with pleurotomy. Patient age, sex, and side of operation were not associated with pleurotomy. Ten (91 %) of the 11 cases were identified intraoperatively. One unrecognized pneumothorax was identified postoperatively with chest roentgenography; no specific intervention was necessary.
CONCLUSIONS
The extraperitoneal flank incision poses a significant risk for pneumothorax. Most pneumothoraces will be recognized intraoperatively. No adverse effects were noted secondary to pneumothorax.
目的
确定供体肾输尿管切除术后气胸的发生率及相关危险因素，并确定术后胸部X线检查的作用。
方法
对在一家机构（耶鲁-纽黑文医院）采用腹膜外腰部切口进行的130例活体供体肾输尿管切除术进行回顾性研究。
结果
11例（8.5%）发生意外胸膜切开术。肋骨切除与胸膜切开术相关。患者年龄、性别和手术侧与胸膜切开术无关。11例中的10例（91%）在术中被发现。术后胸部X线检查发现1例未被识别的气胸；无需特殊干预。
结论
腹膜外腰部切口有发生气胸的重大风险。大多数气胸将在术中被发现。未观察到气胸继发的不良反应。
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