Axillary thoracotomy versus videothoracoscopy for the treatment of primary spontaneous pneumothorax
Axillary thoracotomy versus videothoracoscopy for the treatment of primary spontaneous pneumothorax
复制标题
DOI：
10.1016/j.athoracsur.2003.11.038
复制
发表时间：
2004-08-01
影响因子：
4.6
通讯作者：
de Castro, FR
中科院分区：
文献类型：
--
作者：
Freixinet, JL;Canalís, E;de Castro, FR
背景对原发性自发性气胸患者进行了一项前瞻性随机研究，目的是确定在手术治疗这种情况时，电视胸腔镜手术是否上级腋窝开胸手术。患者被随机分配到两组：电视辅助胸腔镜（A组; n = 46）和腋窝开胸术（B组; n = 44）。所有病例均符合手术指征的既定标准（胸膜引流后复发或持续漏气）。在所有病例中，治疗包括滤过泡或营养不良复合体的心尖段切除术和胸膜机械磨损。该研究评价了以下因素：术后失血量、呼吸功能（最大吸气压和呼气压、第一秒用力呼气量和用力肺活量）、术后疼痛（模拟视觉量表）、镇痛剂的补充剂量、术后并发症、住院时间和恢复正常活动。复发的评估时间至少为两年。两组研究的任何因素均无显著差异。在原发性自发性气胸的外科治疗中，电视胸腔镜和腋窝开胸术的结果相似。并发症发生率低，疼痛程度可接受，无长期后遗症。(C)2004年由胸外科医师协会发布。
Background. A prospective, randomized study was carried out on patients with primary spontaneous pneumothorax, with the aim of determining if video-assisted thoracoscopy is superior to axillary thoracotomy in the surgical treatment of this condition.Methods. Patients were randomly assigned to two groups; video-assisted thoracoscopy (group A; n = 46) and axillary thoracotomy (group B; n = 44). All fit the established criteria for surgical indication (relapse or persistent air leakage after pleural drainage). In all cases the treatment consisted of apical segmentectomy of the blebs or dystrophic complex and pleural mechanical abrasion. The study evaluated the following factors: postoperative blood loss, respiratory function (maximum inspiratory and expiratory pressures, forced expiratory volume in the first second and forced vital capacity), postoperative pain (analog visual scale), supplementary doses of analgesics, postoperative complications, hospital stay, and resumption of normal activity. Relapses were evaluated for the minimum period of time of two years.Results. No significant differences were found in any of the factors studied in either group.Conclusions. Video-assisted thoracoscopy and axillary thoracotomy offer similar results in the surgical treatment of primary spontaneous pneumothorax. The rate of complication is low and the level of pain is acceptable without long-term sequelae. (C) 2004 by The Society of Thoracic Surgeons.