电视胸腔镜手术与开胸手术治疗自发性气胸的比较

VIDEO-ASSISTED THORACOSCOPIC SURGERY VERSUS THORACOTOMY FOR SPONTANEOUS PNEUMOTHORAX

目的 :比较电视胸腔镜手术 (VATS)及开胸手术 (TH)治疗自发性气胸的手术适应证、手术时间 ,围手术期出血量及输血量 ,术后胸管放置时间及住院时间、复发率等。方法 :对 1997年 6月～ 2 0 0 0年 1月期间所行VATS2 2例及TH2 0例结果进行比较。结果 :VATS组手术时间、胸管放置时间及住院时间均较TH组明显缩短 ,围手术期出血量明显少于TH组 ,仅 1例术后输血 2 0 0ml,两组均无并发症、死亡及术后复发。结论 :电视胸腔镜手术创伤小、出血少、手术时间短 ,对心肺功能影响小 ,术后恢复快 ,为原发性自发性气胸 ,尤其是复发性、双侧性者首选治疗 ,继发性自发性气胸应选用开胸手术。

Objective:To review our experience with video-assisted thoracoscopic surgery (VATS)and thoracotomy (TH) for the treatment of spontaneous pneumothorax (SP).Methods:Twenty-two patients underwent VATS and another twenty did TH from Jane 1999 to Jan 2000.Results:The operating time and duration of postoperative chest drainage and hospital stay were significantly shorter in group VATS than in group TH.The amount of perioperative bleeding and blood transfusion was dramatically less in group VATS than ingroup TH. There were no complication and recurrence rate and mortality in both groups. There was no conversion to TH in group VATS.Conclusions:VATS has characteristics of minimal invasion,less bleeding, shorter operating time, less affecting cardio-pulmonary function and quick recovery.It is the first choice for primary SP (PSP),especially for recurrent or bilateral PSP.Secondary SP patients are recommended for TH.