电视胸腔镜或联合辅助小切口治疗自发性气胸28例体会

VATS or VATS-assisted minithoracotomy for spontaneous pneumothorax:a 28 cases anaysis

目的探讨电视胸腔镜或联合辅助小切口在治疗自发性气胸的应用价值。方法采用电视胸腔镜或根据情况联合辅助小切口手术治疗自发性气胸28例，并分析其临床资料。结果手术时间35～70min，50．56±10．15min。术中失血30～150ml，80．00±26．79ml，均不需要输血。术后复查胸片，肺复张良好，术后胸腔引流液50～200ml，86．11±37．12ml，放胸腔引流管时间2～7d，4．06±1．63d。术后住院时间5～12d，7．28±2．05d。术后随访1—21个月，复发1例。没有死亡病例。结论在治疗自发性气胸中，采用电视胸腔镜或联合辅助小切口方法，有效地发挥了电视胸腔镜术野清晰和辅助小切口直视下操作的优点，既能达到微创的目的又能体现辩证施治的原则。

Objective To explore the practical value of VATS or VATS-assisted minithoracotomy（VAMT） for spontaneous pneumothorax. Methods VATS or VAMT were performed in 28 patients with spontaneous pneumothorax, and their clinical data were analyzed. Results There was no operative death in the group VATSs or VAMTs（ total 28 cases） were accomplished successfully. The opera- tion time was 35 ±70rain, 50. 56 ± 10. 15 rain for VATSs or VAMTs. Blood loss was 30 ± 150 ml, 80. 00 ±26. 79 ml and blood transfusion was not needed. The volume of chest drainage was 50± 200 ml,86. 11 ± 37. 12 ml after the operation. The chest drainage tube was removed in 2 to 7 d （4.06 ± 1.63 d） after operation. The postoperative hospital stay was 5± 12 d,7.28±2.05 d. The follow up period was 1 -21 months and there was 1 recurrence in all patients after operation. Conclusion VATS, or VAMT approach could effectively play the clear surgical field of VATS and direct vision operational advantages of supporting small-incision clear, which could achieve the objective of minimally invasive facilities but also reflect the dialectical governance principles in the process of the treatment of spontaneous pneumothorax.