电视辅助胸腔镜治疗肺切除术后脓胸
Video-assisted thoracoscopic management of post-pneumonectomy empyema.
作者信息
Podbielski F J, Halldorsson A O, Vigneswaran W T
机构信息
University of Illinois Division of Cardiothoracic Surgery, Chicago, USA.
出版信息
JSLS. 1997 Jul-Sep;1(3):255-8.
BACKGROUND
Post-pneumonectomy empyema is a major therapeutic challenge in thoracic surgery. The presence or absence of a concomitant bronchopleural fistula directs treatment of this condition. When there is no bronchopleural fistula the condition is classically treated with thoracostomy drainage, irrigation and antibiotic instillation with closure. This approach is, however, associated with a significant rate of primary failure. Alternative modified techniques involve opening the thoracic cavity widely with serial debridement followed by interval closure. Multiple surgical procedures often require a protracted hospital stay.
METHODS
We describe a technique in three patients utilizing video-assisted thoracoscopic surgery for debridement and closure of the pneumonectomy cavity.
CONCLUSION
Advantages of this technique include debridement under direct visualization, low morbidity, and potential for a shorter hospital stay.
背景
肺切除术后脓胸是胸外科的一项重大治疗挑战。是否存在合并支气管胸膜瘘决定了这种情况的治疗方式。当不存在支气管胸膜瘘时，传统的治疗方法是进行胸腔闭式引流、冲洗并注入抗生素，随后闭合胸腔。然而，这种方法的原发性失败率很高。其他改良技术包括广泛打开胸腔，进行系列清创，然后分期闭合。多次外科手术通常需要较长的住院时间。
方法
我们描述了一种在三名患者中使用电视辅助胸腔镜手术进行肺切除腔清创和闭合的技术。
结论
该技术的优点包括在直视下进行清创、发病率低以及有可能缩短住院时间。
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