胸腔镜下缝扎法治疗自发性气胸

目的 比较电视胸腔镜下缝扎肺大疱与Endo-Gia切除肺大疱的手术疗效.方法 电视胸腔镜手术治疗自发性气胸89例,分为缝扎组和Endo-Gia组.缝扎组42例,采用prolene线胸腔镜下缝扎肺大疱;Endo-Gia组47例,采用Endo-Gia切除肺大疱.比较2组手术时间、术中出血量、术后胸管留置时间及手术费用.结果 缝扎组和Endo-Gia组手术时间分别为(68.8±7.0)、(58.6±6.9)min,2组比较差异有统计学意义(t=6.839,P=0.000);术中出血量分别为(48.1±6.5)、(45.8±5.8)ml,2组比较差异无统计学意义(t=1.817,P=0.073);术后胸管留置时间分别为(2.2±0.4)、(2.1±0.5)d,2组比较差异无统计学意义(t=0.287,P=0.775);术后住院时间分别为(4.2±0.9)、(4.3±0.8)d,2组比较差异无统计学意义(t=-0.746,P=0.458);手术费用分别为(2090±131)、(5141±189)元,2组比较差异有统计学意义(t=-87.468,P=0.000).2组术后复查X线胸片肺复张良好,无手术并发症.2组术后各有1例复发,复发率差异无统计学意义(χ2=0.006,P=0.936).结论 胸腔镜下缝扎肺大疱与Endo-Gia切除肺大疱治疗自发性气胸的疗效相当.胸腔镜下缝扎肺大疱治疗自发性气胸与胸腔镜下Endo-Gia切除肺大疱相比,手术时间稍增加,但费用明显降低.

Videothoracoscopic treatment of spontaneous pneumothorax by suturing lung bullae

Objective To compare the outcomes of suturing lung bullae(suturing group)and resecting lung bullae by Endo-Gia(Endo-Gia group)in videothoracoscopic treatment of spontaneous pneumothorax.Methods From March 2002 to March 2007.82 cases of spontaneous pneumothorax experienced video-assisted thoracic surgery.They were divided into two groups.Suturing lung bullae was performed in suturing group(n=40)and resecting lung bullae by Endo-Gia was performed in Endo-Gia group(n=42).The operating time,blood loss during operation,chest drainage time and costs of operation were compared between the two groups.Results The operating time in suturing group and Endo-Gia group was(68.8±7.0)min and(58.6±6.9)min,respectively(t=6.839,P=0.000);the blood loss during operation was(48.1±6.5)ml and(45.8±5.8)ml,without statistically significant difference(t=1.817,P=0.073);the drainage time was(2.2±0.4)d and(2.1±0.5)d,without statistically significant difference(t=0.287,P=0.775);the postoperative hospital stay was(4.2 ±0.9)d and (4.3±0.8)d,without statistically significant difference(t=-0.746,P=0.458);the operation costs were(2090 ±131)yuan and(5141±189)yuan,respectively(t=-87.468,P=0.000).Postoperative chest X-raly examinations showed complete expansion of the lung.No surgery related complication occurred.Only one case experienced recurrence after operation in each group,without statistically significant difference(χ2=0.006,P=0.936).Conelusion There is no difference in outcomes between suturing lung bullae and resecting lung bullae by Endo-Gia in the videothoracoscopic treatmeat of spontaneous pneumothorax.Compared to resecting lung bullae by Endo-Gia,suturing lung bullae slightly increases the operating time,but significantly lowers the costs of operation.