Surgery For Spontaneous Pneumothorax Research Articles

気管食道科領域における鏡視下手術 気道系 胸腔鏡下手術―特に気腫性肺嚢胞について

Thoracoscopic surgery has increased due to the improvement in video endoscopic surgical equipment and technique. From March 1992 to October 1995, 183 patients underwent thoracoscopic surgery at our hospital. 112 cased had spontaneous pneumothorax, 31 mediastinal tumor, 17 mediastinal disease. 11 diffusse intersitial lung disease, 7 pleural disease and 5 giant bulla. In the patients with benign mediastinal tumors (seven cases), we easily resected the tumors, but in four of the ten cases of mediastinal biopsy, we had to covert to open thoracotomy. The procedure for diffuse interstitial lung disease and pneumothorax, a wedge resection of the lung, was performed using an endoscopic stapling device (Endo-GIA) . 125 operations in 112 cases of spontaneous pneumothorax were performed. 15 cases were needed to convert to open thoracotomy due to multiple bullae in six cases, severe adhesion in three, and so on. The postoperative recurrence rate in spontaneous pneumothorax was approximately 10%. Reoperation was carried out in six cases (ten times) . In five cases, reoperation was carried out using only thoracoscopic procedures. We conclude that thoracoscopic surgery for spontaneous pneumothorax is warranted, but careful observation and exploration during operation during operation are necessary.

原発性自然気胸治療における壁側胸膜部分切除 特に胸腔鏡下手術での再発防止法としての意義

原発性自然気胸治療における壁側胸膜部分切除 特に胸腔鏡下手術での再発防止法としての意義

THORACOSCOPIC SURGERY FOR SPONTANEOUS PNEUMOTHORAX

Thoracoscopic surgery for spontaneous pneumothorax has been successfully performed in 45 cases. Minimal invasiveness which is the purpose of thoracoscopic surgry was attained because all patients could be discharged with short hospital stay and without major complications. Recurrence rate of pneumothorax after thoracoscopic surgery was 2.2% that was acceptable comparing with thoracotomy (1.5%). From clinical study of thoracotomy cases, more than 95% of the patients under 30 years old can be treated well thoracoscopically, using skilled suturing tecnhique.