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首页> 外文期刊>Surgical Endoscopy >Limited axillary thoracotomy vs video-assisted thoracoscopic surgery for spontaneous pneumothorax.
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Limited axillary thoracotomy vs video-assisted thoracoscopic surgery for spontaneous pneumothorax.

机译：自发性气胸的有限腋窝胸廓切开术与电视辅助胸腔镜手术。

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BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has been reported to have a higher pneumothorax recurrence rate than limited axillary thoracotomy (LAT). We investigated the cause of pneumothorax recurrence after VATS by comparing surgical results for VATS and LAT. METHODS: Ninety-five patients with spontaneous pneumothorax underwent resection of pulmonary bullae by VATS (n = 51) or LAT (n = 44). Operating duration, bleeding during surgery, number of resected bullae, duration of postoperative chest tube drainage, postoperative hospital stay, postoperative complication, and pneumothorax recurrence were analyzed to compare VATS and LAT in a retrospective study. RESULTS: The duration of surgery, postoperative chest tube drainage, and postoperative hospital stay was significantly shorter in VATS than in LAT cases (p < 0.0005 and p < 0.005). Bleeding during surgery was significantly less in VATS than in LAT cases (p < 0.005). Numbers of resected bullae were significantly lower in VATS (2.7 +/- 2.1) than in LAT cases (3.9 +/- 2.7) (p < 0.05). Postoperative pneumothorax recurrence was more frequent in VATS (13.7%) than in LAT cases (6.8%), but there was no significant difference. CONCLUSIONS: VATS has many advantages over LAT in treating spontaneous pneumothorax, although the pneumothorax recurrence rate in VATS cases was double that in LAT cases. The lower number of resected bullae in VATS than in LAT cases suggests that overlooking bullae in operation could be responsible for the high recurrence rate in VATS cases. We recommend additional pleurodesis in VATS for spontaneous pneumothorax to prevent postoperative pneumothorax recurrence.
机译：背景：据报道，电视胸腔镜手术（VATS）的气胸复发率要高于有限的腋窝胸廓切开术（LAT）。通过比较VATS和LAT的手术结果，我们调查了VATS后气胸复发的原因。方法：95例自发性气胸患者接受了VATS（n = 51）或LAT（n = 44）切除肺大疱。在一项回顾性研究中，分析了手术时间，术中出血，切除的大疱数量，术后胸腔引流时间，术后住院时间，术后并发症和气胸复发，以比较VATS和LAT。结果：VATS的手术时间，术后胸腔引流和术后住院时间明显少于LAT患者（p <0.0005和p <0.005）。 VATS手术期间的出血明显少于LAT病例（p <0.005）。 VATS（2.7 +/- 2.1）切除的大疱数量明显少于LAT病例（3.9 +/- 2.7）（p <0.05）。 VATS术后气胸复发的发生率（13.7％）比LAT病例（6.8％）的发生率高，但差异无统计学意义。结论：尽管VATS病例的气胸复发率是LAT病例的两倍，但VATS在治疗自发性气胸方面比LAT有许多优势。 VATS中切除大疱的数量少于LAT病例，这表明在手术中俯视大疱可能是VATS病例高复发率的原因。对于自发性气胸，我们建议在VATS中进行其他胸膜固定术，以防止术后气胸复发。

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