|
|
Application effect of thoracoscopy without tube in the resection of pulmonary bullae |
WEI Shenhai1 TIAN Yulin2 WU Bingqun1 HU Pengcheng1 TIAN Jintao1 SONG Xiaoping1 PAN Shouqiang1 |
1.Deartment of Thoracic Surgery, the First Hospital of Tsinghua University, Beijing 100016, China;
2.Department of Anesthesia, the First Hospital of Tsinghua University, Beijing 100016, China |
|
|
Abstract Objective To evaluate the advantages and safety of thoracoscopy without tube in the resection of pulmonary bullae. Methods Fifty-one patients in the First Hospital of Tsinghua University from July 2017 to April 2021 planned to undergo the resection of pulmonary bullae due to pneumothorax were selected as the research objects and divided into the thoracoscopy without tube group and thoracoscopy with tracheal intubation group according to their wishes. In the thoracoscopy without tube group, 20 patients underwent the resection of pulmonary bullae by thoracoscopy without tube. In the thoracoscopy with tracheal intubation group, 31 patients underwent the resection of pulmonary bullae by thoracoscopy with tracheal intubation. The duration of anesthesia, operation time, minimum pulse oxygen saturation during the operation, blood loss during the operation, postoperative retention time in the operating room, retention time of drainage tube, postoperative addition of painkillers, postoperative hospital stay, occurrence of cough or pharyngeal discomfort within one month after the operation, and recurrence of pneumothorax within six months after the operation were recorded and compared between the two groups. Results The duration of anesthesia and postoperative retention time in the operating room in the thoracoscopy without tube group were shorter than those in the thoracoscopy with tracheal intubation group, the minimum pulse oxygen saturation during the operation and the occurrence of cough or pharyngeal discomfort within one month after the operation were lower than those in the thoracoscopy with tracheal intubation group, the differences were statistically significant (P<0.05). There were no significant differences in the retention time of drainage tube, postoperative addition of painkiller, postoperative hospital stay, and recurrence of pneumothorax within six months after the operation between the two groups (P>0.05). Conclusion Thoracoscopy without tube in the resection of pulmonary bullae can shorten the time of anesthesia and reduce postoperative complications such as cough and pharyngeal discomfort, which is safe and reliable and worthy of further promotion.
|
|
|
|
|
[1] Batchelor TJP,Rasburn NJ,Abdelnour-Berchtold E,et al. Guidelines for enhanced recovery after lung surgery:recommendations of the Enhanced Recovery After Surgery(ERAS?)Society and the European Society of Thoracic Surgeons(ESTS)[J]. Eur J Cardiothorac Surg,2019,55(1):91-115.
[2] 朱晓莉,陈峰,张祖贻,等.胸部CT对肺大疱诊断的评价[J].中华内科杂志,1997(7):48-49.
[3] Inderbitzi RG,Leiser A,Furrer M,et al. Three years’experience in video-assisted thoracic surgery(VATS)for spontaneous pneumothorax [J]. J Thorac Cardiovasc Surg,1994, 107(6):1410-1415.
[4] Sugimoto S,Date H,Sugimoto R,et al. Thoracoscopic operation with local and epidural anesthesia in the treatment of pneumothorax after lung transplantation [J]. J Thorac Cardiovasc Surg,2005,130(4):1219-1220.
[5] Rocco G,Romano V,Accardo R,et al. Awake single-access(uniportal)video-assisted thoracoscopic surgery for peripheral pulmonary nodules in a complete ambulatory setting [J]. Ann Thorac Surg,2010,89(5):1625-1627.
[6] Pompeo E,Tacconi F,Mineo D,et al. The role of awake video-assisted thoracoscopic surgery in spontaneous pneumothorax [J]. J Thorac Cardiovasc Surg,2007,133(3):786- 790.
[7] Pompeo E,Mineo TC. Awake pulmonary metastasectomy [J]. J Thorac Cardiovasc Surg,2007,133(4):960-966.
[8] Pompeo E,Mineo D,Rogliani P,et al. Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules [J]. Ann Thorac Surg,2004,78(5):1761-1768.
[9] Mukaida T,Andou A,Date H,et al. Thoracoscopic operation for secondary pneumothorax under local and epidural anesthesia in high-risk patients [J]. Ann Thorac Surg,1998,65(4):924-926.
[10] Mineo TC,Pompeo E,Mineo D,et al. Awake nonresectional lung volume reduction surgery [J]. Ann Surg,2006,243(1):131-136.
[11] 李简,王晓新,贺钢锋,等.非全麻下电视辅助胸腔镜手术治疗复发性气胸的探讨[J].中国现代医学杂志,2001, 11(4):11-12,114-115.
[12] 李简,王晓新,贺钢枫,等.局麻下经电视胸腔镜肺肿物切除术[J].中国肿瘤临床,2001,28(6):428-430.
[13] Chen JS,Cheng YJ,Hung MH,et al. Nonintubated thoracoscopic lobectomy for lung cancer [J]. Ann Surg,2011, 254(6):1038-1043.
[14] Hung MH,Hsu HH,Chen KC,et al. Nonintubated thoracoscopic anatomical segmentectomy for lung tumors [J]. Ann Thorac Surg,2013,96(4):1209-1215.
[15] Gonzalez-Rivas D,Fernandez R,de la Torre M,et al. Single-port thoracoscopic lobectomy in a nonintubated patient:the least invasive procedure for major lung resection [J]. Interact Cardiovasc Thorac Surg,2014,19(4):552-555.
[16] Hung MH,Cheng YJ,Chan KC,et al. Nonintubated uniportal thoracoscopic surgery for peripheral lung nodules [J]. Ann Thorac Surg,2014,98(6):1998-2003.
[17] Shao W,Phan K,Guo X,et al. Non-intubated complete thoracoscopic bronchial sleeve resection for central lung cancer [J]. J Thorac Dis,2014,6(10):1485-1488.
[18] Hung WT,Hsu HH,Hung MH,et al. Nonintubated uniportal thoracoscopic surgery for resection of lung lesions [J]. J Thorac Dis,2016,8(S3):S242-S250.
[19] Liang H,Gonzalez-Rivas D,Zhou Y,et al. Nonintubated Anesthesia for Tracheal/Carinal Resection and Reconstruction [J]. Thorac Surg Clin,2020,30(1):83-90.
[20] Wu CY,Chen JS,Lin YS,et al. Feasibility and safety of nonintubated thoracoscopic lobectomy for geriatric lung cancer patients [J]. Ann Thorac Surg,2013,95(2):405- 411.
[21] 地力木拉提·艾山江,孙清超,李德生,等.剑突下与侧胸入路电视胸腔镜同期行双侧肺大疱切除术近期疗效的meta分析[J].中国医药科学,2022,12(10):60-64.
[22] 夏冰.单孔胸腔镜下切除术在自发性气胸并肺大疱患者中的应用效果[J].中国当代医药,2022,29(26):74-76, 80.
[23] 李仁鹏,韩文健,黎琰,等.无管化电视辅助胸腔镜手术治疗自发性气胸的临床应用[J].中国胸心血管外科临床杂志,2020,27(1):57-60.
[24] 沈柏儒,宋长山,吴旭辉,等.无管胸腔镜手术与传统胸腔镜手术的对比分析[J].中国继续医学教育,2020,12(35):106-109.
[25] 李仁鹏,黎琰,胡文滕,等.无管化单孔胸腔镜肺大疱切除术治疗自发性气胸18例[J].中国微创外科杂志,2019, 19(10):942-944.
[26] 赖习华,吴稚晖,陈广,等.无管化与常规双腔气管插管单孔胸腔镜肺大疱切除术的比较[J].中国微创外科杂志,2019,19(11):993-995,1003.
[27] Liu J,Cui F,Pompeo E,et al. The impact of non-intubated versus intubated anaesthesia on early outcomes of video- assisted thoracoscopic anatomical resection in non-small- cell lung cancer:a propensity score matching analysis [J]. Eur J Cardiothorac Surg,2016,50(5):920-925.
[28] Hung MH,Chan KC,Liu YJ,et al. Nonintubated thoracoscopic lobectomy for lung cancer using epidural anesthesia and intercostal blockade:a retrospective cohort study of 238 cases [J]. Medicine(Baltimore),2015,94(13):e727. |
|
|
|