胸腔镜治疗继发性自发性气胸的价值

The Value of Video-Assited Thoracic Surgery for the Treatment of Secondary Spontaneous Pneumothorax

目的 评价电视胸腔镜手术 (Video AssistedThoracicSurgery ,VATS)处理继发性自发性气胸 (SecondarySpotaneouspneumothorax,SSP)的价值。 方法 回顾分析 1993年 7月～ 2 0 0 1年 1月 7年来手术治疗的 90例SSP ,比较VATS(A组 )、剖胸组 (B组 )和胸腔引流组 (C组 )术后各参数。 结果 A、B组术后胸管引流时间低于C组 (P <0 .0 5 ) ,A组术后胸管引流及住院时间最短 (P <0 .0 1)。 3组术后并发症率分别为 2 1 4%、2 5 %和 38% (P <0 .0 5 ) ,近期漏气率分别为 16 2 %、12 5 %和 31% ,远期复发率分别为 5 4%、4 3 %和 2 0 %。

Ojective To evaluate the value of video-assisted thoracic surgery for the treatment of secondary spontaneous pneumothorax. Methods 90 patients were treated by VATS (A group, n=37), thoracotomy (B group, n=24) or chest tube drainage (C group, n=29) for secondary spontaneous pneumothorax (SSP) from January 1993 to January 2001. Postoperative paramenters of three groups, such as hospitalized days, duration of drainage, incidence of complication and recurrences were reviewed retrospectively. Results The duration of drainage in A, B group was shorter than that in C group ( P <0.05). The hospitalized days in A group were superior to those of other groups. The postoperative morbidities of three groups were 21.4%, 25% and 38% ( P <0.05) respectively. The short term and long ferm recurrence rates of the three groups were 16.2%, 12.5% versus 31%, and 5.4%, 4.3% versus 20% respectively. Conclusions The therapeutic result of VATS for treating SSP was reliable and better as compared with open thoracotomy or tube drainage in selected patient.