胸腔镜双侧一期手术治疗自发性气胸

EXPERIENCE WITH ONE-STAGE BILATERAL VATS FOR SPONTANEOUS PNEUMOTHORAX

目的 :探讨胸腔镜双侧一期手术治疗自发性气胸的手术方法、并发症 ,评价该术式的可行性、安全性。方法 :该组 2 1例均为双侧同时自发气胸或一侧反复自发气胸合并对侧肺大泡的病例 ,应用胸腔镜双侧一期手术治疗。结果 :该组病例均经胸腔镜手术治疗 ,术后出现漏气 (大于 4d) 2例 ,术后复发性肺水肿需机械通气 1例 ,术后复发 1例 ,无死亡病例 ,均经手术治疗痊愈。随访 7～ 77个月 (平均 32 .7个月 )。与该组同期 12 7例单侧自发性气胸胸腔镜手术治疗、术后并发症比较 (P >0 .0 5 ) ,无显著差异。结论 :胸腔镜一期手术是治疗双侧自发性气胸或一侧气胸而另一侧证实有肺大泡的安全有效的术式。

Objective:Evaluating the operative methods,complication,feasibiltity and safety of one-stage treatment by thoracoscopy for bilateral pneumothorax or pneumothorax combined with contralateral bullae.Methods:21 patients diagnosed as simultaneous bilateral pneumothorax or ipsilateral recurrent pneumothorax with contralateral bullaes received one-stage treatment by bilateral thoracoscopy.Results:all patients received VATS,postoperative complications include prolonged air leak over 4 days(2 cases), reexpansion pulmonary edema (1 case),and one patient required temporarily mechanical ventilation.There were no postoperative death.All patients recovered smoothly.Follow-up time ranges from 7 to 77 months (mean 32.7 months).Compared with the 127 thoracopcopic procedures of unilateral pneumothorax,there's no statistics difference in complications (χ 2=1.7247, P >0.05). Conclusions:one-stage VATS is a safe and effective procedure for bilateral spontaneous pneumothorax or pneumothorax combined with contralateral bullae.