电视胸腔镜手术治疗巨大肺大疱

目的 :探讨电视胸腔镜手术治疗巨大肺大疱的可行性和效果。方法 :对 1 4例 (1 5侧肺叶 )临床资料进行回顾性分析。患者肺大疱均占据胸腔 >50 % ,术前呼吸困难 4级 7例 ,5级 7例。结果 :本组 1 4例病人 1 5侧肺叶 ,其中 2侧肺叶在单纯胸腔镜下完成大泡切除 ,1 3侧肺叶在小切口辅助下施行了肺大泡切除。手术过程顺利。手术时间 90～ 2 4 0min ,出血 50～ 80 0ml。术后呼吸困难情况明显改善 :指标提升 1级 8例 ,提升 2级 6例 (如 5级提升至 3级 )。术后主要并发症为术后漏气。结论 :电视胸腔镜手术治疗巨大肺疱是可行和安全的 ,切割方法和壁层胸膜摩擦固定术是防止复发的首选方法

THORACOSCOPIC BULLECTOMY FOR GIANT BULLOUS

Objective:To evaluate the technically feasibleness and the effects of VATS in the treatment of giant bullous. Methods:14 cases with giant bullus ( 15 lobes ) were retrospectively analyzed. Giant bullae occupied at least 50% of hemithorax, All the patients were shortness of breath. Including 7 cases ,grade 4;7 cases,grade 5. Results:14 cases with 15 lobes, 2 bullectomies were done by video-assisted theracoscopy; 13 bullectomies were performed by combination of thoracoscopy and mini thoracic incisions. All procedures were successfully done. The operating time ranged from 90 to 240 minutes. The bleeding from 50 to 800ml. Lung function was significantly improved in all patients after surgery the shortness of breath was improved too. Index of respiratory function in all cases were improved. The main post-operation complication is air leakage.Conclusion:Thoracoscopic bullectomy for giant bullous emphysema is a technically feasible and safety procedure, using EndoGIA and pleurodesis with mechanical abrasion using a sponge is the first choice in the thoracoscopic bullectomy for giant bullous.