单孔桶与双孔桶治疗自发性气胸

M. Sallam, H. Elkhayat, Ahmed Elminshawy
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摘要

背景:为了提高自发性气胸视频辅助胸外科手术(VATS)患者的术后效果,有必要确定每种VATS治疗方法在这类患者中的应用差异。先前的研究揭示了一种技术优于另一种技术的讨论。材料与方法:对2017年1月至2019年4月在阿西尤特大学心脏医院接受VATS治疗的自发性气胸(原发性或继发性)患者进行对比研究。本研究纳入的患者为PSP气胸线突出的大泡型、复发性气胸、双侧气胸、既往有对侧气胸病史、自发性血胸、首发患者漏气超过5天并有引流管。患者分为两组,A组患者行单孔VATS, B组患者行双孔VATS。结果:本组32例患者中,原发性自发性气胸22例,继发性自发性气胸10例。男女性别比(M\F ratio)为3.2:1。年龄的平均±SD分别为PSP(30.04±10.245)和SSP(50.43±9.071)。18例患者行单孔VATS, 14例行双孔VATS。单孔VATS平均手术时间为81.5±33.74,双孔VATS平均手术时间为109.79±25.37 (p = 0.014)。单口和双口VATS在疼痛、漏气、并发症、住院时间、复发和死亡率方面没有显著的统计学差异。尽管在死亡率方面没有统计学差异(p = 0.492),但在被称为间质性肺纤维化的单一VATS组中有2例死亡。结论:除手术时间外,两种手术方法无明显差异。
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Uniport vats versus biport vats in treatment of spontaneous pneumothorax
Background: To enhance postoperative outcomes in patients having videoassisted thoracic surgery (VATS) for spontaneous pneumothorax, it is necessary to determine the difference between the uses of each VATS treatment in such patients. Previous studies have revealed a discussion over the preference of one technique over the other. Materials and Methods: A comparative study was conducted on spontaneous pneumothorax patients (primary or secondary) undergoing VATS in Assiut University Heart Hospital from January 2017 till April 2019. Patients included in our study were prominent bullous forms in PSP pneumothorax lines, recurrent pneumothorax, bilateral pneumothorax, previous history of contralateral pneumothorax, and spontaneous hemothorax, air leakage more than five days with drainage catheter for first-episode patients. Patients were divided into two groups as group A patients who underwent uniport VATS procedure, and group B patients who underwent biport VATS procedure. Results: The study included 32 patients, 22 were primary spontaneous pneumothorax (PSP), while 10 were secondary spontaneous pneumothorax (SSP). The male to female ratio (M\F ratio) was 3.2:1. The mean ± SD for age was 30.04 ± 10.245 in PSP and was 50.43 ± 9.071 in SSP. Eighteen patients underwent uniport VATS, and 14 underwent biport VATS. The mean time for operation was 81.5 ± 33.74 in uniport VATS versus 109.79 ± 25.37 in biport VATS (p = 0.014). No significant statistical difference was found between uniport and biport VATS regarding pain, air leak, complications, hospital stay, recurrence, and mortality. Despite no statistical difference regarding mortality (p = 0.492), there were two mortalities in the uniport VATS group known as interstitial pulmonary fibrosis. Conclusions: We concluded that there are no differences between both techniques except for operative time.
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