[1]李潇蔡纯周槟娄蕾沈玲会张刚周晓彤俞钢.胸腔镜手术治疗婴幼儿先天性肺气道畸形术后免胸管留置的初步研究[J].中国微创外科杂志,2025,01(2):65-69.
　Li Xiao,Cai Chun,Zhou Bin,et al.Primary Study of Videoassisted Thoracoscopic Surgery Without Chest Tube Drainage for Infants With Congenital Pulmonary Airway Malformation[J].Chinese Journal of Minimally Invasive Surgery,2025,01(2):65-69.
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胸腔镜手术治疗婴幼儿先天性肺气道畸形术后免胸管留置的初步研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2025年2期
页码:
65-69
栏目:
临床论著
出版日期:
2025-02-25

文章信息/Info

Title:
Primary Study of Videoassisted Thoracoscopic Surgery Without Chest Tube Drainage for Infants With Congenital Pulmonary Airway Malformation
作者:
李潇蔡纯周槟娄蕾沈玲会张刚周晓彤俞钢
(广州医科大学附属第三医院小儿外科广东省产科重大疾病重点实验室广东省妇产疾病临床医学研究中心,广州510150)
Author(s):
Li Xiao;  Cai Chun;  Zhou Bin;  et al.
Department of Pediatric Surgery, Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou 510150, China
关键词:
胸腔镜手术; 先天性肺气道畸形; 胸管; 胸腔引流
Keywords:
Videoassisted thoracoscopic surgery; Congenital pulmonary airway malformation; Chest tube; Chest drainage
文献标志码:
A
摘要:
目的探讨胸腔镜手术治疗婴幼儿先天性肺气道畸形(congenital pulmonary airway malformation，CPAM)免胸管留置的可行性和安全性。方法回顾分析我科2019年5月~2022年8月胸腔镜手术治疗145例婴幼儿CDAM的临床资料，其中6例手术结束时留置胸管，139例患儿手术结束时不留置胸管，肺段切除99例，肺叶切除36例，肺叶合并肺段切除4例，观察临床疗效及术后并发症。结果145例行胸腔镜手术，无中转开胸，无围手术期死亡。6例手术结束时留置胸管，余139例患儿手术结束时不留置胸管。手术时间(42.0±16.6)min，术中出血量(2.7±2.0)ml。术后因气胸或胸腔积液置入胸管患儿6例，置入率4.3%；余133例患儿常规术后第3天复查胸部X线片，其中8例术侧轻度气胸（肺压缩<20%）均不需要进一步处理，出院前复查胸片，气胸均基本吸收。所有患儿均顺利康复出院，住院时间(6.6±1.3)d。结论胸腔镜治疗婴幼儿CPAM术后不置胸管对选择性患儿是安全、可行的。
Abstract:
ObjectiveTo evaluate the technical feasibility and safety of videoassisted thoracoscopic surgery (VATS) without chest tube placement for infants with congenital pulmonary airway malformation (CPAM).MethodsClinical data of 145 infants with CPAM treated by VATS from May 2019 to August 2022 were retrospectively analyzed. Six cases had a chest tube placement at the end of the surgery, while 139 cases did not. Among them, there were 99 segmental lobectomies, 36 lobectomies, and 4 lobectomies and segmental lobectomies. Clinical efficacy and postoperative complications were observed.ResultsAll the 145 patients underwent resection by VATS without conversion to thoracotomy. There was no mortality during the perioperative period. In the 139 cases without chest tube placement at the end of surgery, the operation time was (42.0±16.6) min, and the intraoperative blood loss was (2.7±2.0) ml. The were 6 cases who were given indwelling drainage tube for pneumothorax or pleural effusion after surgery, the rate of recatheterization being 4.3%. The remaining 133 cases had chest Xray review on the third day after routine surgery.Among them,8 cases had mild pneumothorax (lung compression <20%) on the surgical side, which did not require further treatment. Before discharge, chest Xray reexamination showed that pneumothorax was basically absorbed. All the patients were discharged with uneventful recovery, and the hospital stay was (6.6±1.3)d.ConclusionVATS without chest tube placement is a safe and feasible surgical procedure for some selective infants with congenital pulmonary airway malformation.

参考文献/References:

[1] Wick MR. Hamartomas and other tumor-like malformations of the lungs and heart. Semin Diagn Pathol, 2019, 36(1): 2-10.
[2] Wong KKY, Flake AW, Tibboel D, et al. Congenital pulmonary airway malformation: advances and controversies. Lancet Child Adolesc Health, 2018, 2(4): 290-297.
[3] 中华医学会小儿外科学分会普胸外科学组，中国医疗保健国际交流促进会妇儿医疗保健分会. 先天性肺气道畸形诊疗中国专家共识(2021版). 中华小儿外科杂志, 2021, 42(8): 679-687.
[4] Lu TY, Chen JX, Chen PR, et al. Evaluation of the necessity for chest drain placement following thoracoscopic wedge resection. Surg Today, 2017, 47(5): 606-610.
[5] Ueda K, Haruki T, Murakami J, et al. No drain after thoracoscopic major lung resection for cancer helps preserve the physical function. Ann Thorac Surg, 2019, 108(2): 399-404.
[6] 任占良, 古轶, 任小朋, 等. 单孔胸腔镜肺良性疾病术后免胸管的临床疗效及安全性. 中国医师杂志, 2019, 21(7): 1083-1084.
[7] 卢礼卿, 程远大, 张春芳. 单孔胸腔镜手术无胸管留置在胸外科快速康复中的应用. 中华胸部外科电子杂志, 2017, 4(3): 159-163.
[8] Nakashima S, Watanabe A, Mishina T, et al. Feasibility and safety of postoperative management without chest tube placement after thoracoscopic wedge resection of the lung. Surg Today, 2011, 41(6): 774-779.
[9] 黄同海, 王光锁, 丁光贵, 等. 单孔全胸腔镜手术后不置胸管治疗年轻患者自发性气胸. 中国微创外科杂志, 2016, 16(6): 535-537.

备注/Memo

备注/Memo:
通讯作者，Email:yugang1959@126.com
更新日期/Last Update: 2025-04-29