Is there a benefit of awake thoracoscopic surgery in patients with secondary spontaneous pneumothorax?
Is there a benefit of awake thoracoscopic surgery in patients with secondary spontaneous pneumothorax?
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DOI：
10.1016/j.jtcvs.2011.07.067
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发表时间：
2012-03-01
影响因子：
6
通讯作者：
Kondo, Takashi
中科院分区：
文献类型：
--
作者：
Noda, Masafumi;Okada, Yoshinori;Kondo, Takashi
目的：本研究的目的是回顾性比较清醒和麻醉患者的电视胸腔镜手术治疗继发性自发性气胸的结果。方法：对57例连续接受电视胸腔镜手术治疗继发性自发性气胸的患者进行回顾性分析。在这些患者中，15例在硬膜外和/或局部麻醉（ELA）下进行手术，42例在全身麻醉下进行手术。使用倾向评分匹配，我们确定了可比较的患者组：ELA组和全身麻醉组（每组n = 8）。我们比较了手术室停留时间，手术时间，术后第1天的术后血液学数据，术后并发症，住院时间，以及ELA和全身麻醉组之间的住院死亡率。结果：倾向评分匹配后，ELA组的手术室停留时间明显缩短（P = 0.006）。ELA组术后呼吸系统并发症（包括肺炎和急性呼吸窘迫综合征）的发生率较低（P = 0.02）。两组术后住院时间和住院死亡率无差异。结论：ELA组术后呼吸系统并发症发生率较低。对于继发性自发性气胸的患者，清醒时进行胸腔镜手术的总体发病率可接受。（《胸血管外科杂志》2012;143：613-6）
Objectives: The purpose of the present study was to retrospectively compare the outcomes of video-assisted thoracic surgery in awake and anesthetized patients in the treatment of secondary spontaneous pneumothorax.Methods: A total of 57 consecutive patients who underwent video-assisted thoracic surgery for secondary spontaneous pneumothorax was retrospectively analyzed. Of these patients, 15 underwent surgery under epidural and/or local anesthesia (ELA) and 42 under general anesthesia. Using propensity score matching, we identified comparable patient groups: the ELA group and general anesthesia group (n = 8 each). We compared the duration of operating room stay, operating time, postoperative hematologic data on postoperative day 1, postoperative complications, duration of hospital stay, and the incidence of hospital death between the ELA and general anesthesia groups.Results: After propensity score matching, the duration of operating room stay was significantly shorter in the ELA group (P = .006). The incidence of postoperative respiratory complications, including pneumonia and acute respiratory distress syndrome, was lower in the ELA group (P = .02). The duration of postoperative hospital stay and the incidence of hospital death were not different between the 2 groups.Conclusions: The ELA group had a lower incidence of postoperative respiratory complications. Awake video-assisted thoracic surgery can be performed with an acceptable overall morbidity for patients with secondary spontaneous pneumothorax. (J Thorac Cardiovasc Surg 2012;143:613-6)