269例肺切除术后支气管胸膜瘘发生情况分析

Management of Bronchial Stumpin Pulmonary Resections:A Review of 269 Cases

目的分析肺切除术运用不同方法闭合支气管残端的效果,以期减少术后支气管胸膜瘘的发生。方法回顾性分析2004年12月～2008年12月我院269例次肺切除术支气管残端闭合方法,其中42例采用缝线缝合,占15.6%;应用切割缝合器共227例,占84.4%。结果术后共发生5例支气管胸膜瘘(总发生率为1.9%):其中有1例是采用传统缝线缝合(占2.4%),4例是采用缝合器缝合(占1.8%),两种方法无明显统计学差异。结论采用不同方式闭合支气管残端仍存在手术失败,但其发生率是可以接受的,并且术后支气管胸膜瘘的发生率没有明显区别。

Objective To analyze the bronchial stump closure by different methods during pneumonectomy to reduce the incidence of the postoperative bronchopleural fistula. Methods Bronchial closure in 269 consecutive stumps in pulmonary resection from 2004 to 2008 was reviewed in terms of the incidence of troubles related to BPF formation. Forty-two stumps （15.6%） were closed by manual suturing and 227 （84. 4%） by mechanical stapling. Results Five BPFs developed postoperatively among the 269 closures （overall incidence, 1.9%）： one after manual suturing （2.4%） and four after stapling （1.8%）, and this difference was not statistically significant. Conclusion Although bronchial closure was accompanied by failure, its incidence was acceptable and was not directly associated with the development of BPF postoperatively, as long as properly repaired.