电视胸腔镜处理自发性气胸疗效分析

A Clinical Analysis of Video-Assisted Thoracoscopic Surgery for Spontaneous Pneumothorax

目的 评价电视胸腔镜 (VATS)处理自发性气胸的疗效。 方法 将手术治疗的自发性气胸分为VATS组和剖胸组 ,按原发性和继发性进行术中术后各种参数的回顾性分析。 结果 与剖胸组相比 ,VATS组在术中出血量、手术时间及术后住院时间方面明显优于对照组。VATS组和剖胸组术后并发症发生率分别为 8.4%和 2 0 .9% (P <0 .0 5 ) ,近期漏气率分别为 5 .6%和 7% (P >0 .0 5 ) ,远期复发率分别为 2 .8%和 2 .3% (P >0 .0 5 )。 结论 与剖胸术比较 ,VATS更易被病人接受 ,总的疗效较优 。

Objective To evaluate the effect of video-assisted thoracoscopic surgery for spontaneous pneumothorax. Methods From Jan. 1993 to Oct. 2001, 186 patients were treated by VATS (n=143) or thoracotomy (n=43) for primary (PSP) and secondary (SSP) spontaneous pneumothorax. The intraoperative and postoperative parameters of VATS such as volume of blood loss, duration of operative time, length of hospital stay, duration of drainage, complications and recurrences were retrospectively compared with those of the control group of thoracotomy. Results The volume of blood loss, duration of operative time, length of hospital stay of the VATS group were superior to those of the thoracotomy group. The postoperative morbidity of the VATS group and thoracotomy group were respectively 8.4% and 20.9%(P<0.05). The recent and late recurrence rates of the groups were respectively 5.6% versus 7%(P>0.05), 2.8% versus 2.3%(P>0.05). Conclusion VATS is more acceptable by the patients and more efficient as compared with the open thoracotomy. VATS can be considered as the first choice for SP.