Video-Assisted Thoracic Surgery for Bronchiectasis
Video-Assisted Thoracic Surgery for Bronchiectasis
复制标题
支气管扩张的视频辅助胸外科手术
DOI：
10.1016/j.athoracsur.2010.08.035
复制
发表时间：
2011-01-01
影响因子：
4.6
通讯作者：
Gao, Wen
中科院分区：
文献类型：
--
作者：
Zhang, Peng;Zhang, Fujun;Gao, Wen
背景支气管扩张症是世界上诊断的常见疾病之一。治疗方法无重大改进，疗效有限，给该病的治疗带来了巨大挑战。电视胸腔镜手术（VATS）为支气管扩张症的治疗提供了新的选择。本研究的目的是介绍我们的经验，电视胸腔镜治疗支气管扩张症，并比较这与开胸手术在我们的机构。方法回顾性分析2005年1月至2009年12月间行胸腔镜肺叶切除术和普通肺叶切除术治疗支气管扩张症的病例资料。279例行开胸手术，52例行胸腔镜肺叶切除术。从279例开胸手术患者中选择52例，并与VATS组进行比较。15例（28.8%）患者在VATS中观察到胸膜粘连。7例中转开胸。两组术中出血量和中位手术时间无差异，但VATS组患者住院时间短（p = 0.045），并发症少（p = 0.039）。49例（94%）患者经电视胸腔镜手术后痊愈，46例（88%）患者经开胸手术后痊愈。电视胸腔镜肺叶切除术治疗局限性支气管扩张症是一种安全、有效的手术方法。(Ann Thorac Surg 2011; 91：239-43）（C）2011年，胸外科医师协会
Background. Bronchiectasis is one of the common diseases diagnosed in the world. No major improvement for the treatment approaches and limited efficacy promote a big challenge for management of this disease. Video-assisted thoracoscopic surgery (VATS) offers a new choice for the treatment of bronchiectasis. The purpose of this study was to present our experience of VATS for bronchiectasis and to compare this with thoracotomy in our institution.Methods. We reviewed the medical records of patients who underwent VATS lobectomy and general lobectomy for bronchiectasis between January 2005 and December 2009.Results. A total of 279 patients underwent thoracotomy, 52 patients underwent attempted VATS lobectomy. Fifty-two patients from 279 patients for thoracotomy were selected and compared with the VATS group. Pleural adhesion was observed in 15 patients (28.8%) in VATS. The VATS lobectomy was converted to open thoracotomy in 7 patients. There was no difference in the blood loss and median operative time between the two groups, but the patients with VATS had shorter length of stay in hospital (p = 0.045), fewer complications (p = 0.039) than those with thoracotomy. Forty-nine (94%) and 46 (88%) patients fully recovered after operation by VATS and thoracotomy, respectively.Conclusions. Video-assisted thoracoscopic lobectomy in localized bronchiectasis is a safe and more efficient procedure in selected patients with better recovery. (Ann Thorac Surg 2011; 91: 239-43) (C) 2011 by The Society of Thoracic Surgeons