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Video-Assisted Thoracoscopic Surgery with Simultaneous Minithoracotomy for Spontaneous Hemopneumothorax
並列摘要
Background: Spontaneous hemopneumothorax, a life-threatening and rare disorder, complicated from the primary spontaneous pneumothorax is thought of as a surgical emergency. We prospectively investigate the safety and utility of the videoassisted thoracoscopic surgery with simultaneous minithoracotomy (VATS+MT) in the treatment of spontaneous hemopneumothorax. Methods: From Jan. 1998 to Oct. 2001, 208 patients with primary spontaneous pneumothorax were treated in our hospital. Among these patients, 12 (5.8%) spontaneous hemopneumothorax occurred and all happened in the first episode of spontaneous pneumothorax. After tube thoracostomy, the amount of blood drainage ranged from 500 to 1,500 ml (mean 869 ml). Eight patients were treated by VATS+MT. Results: During surgery, the sources of hemorrhage were all from the torn aberrant vessels between the apical blebs and the parietal pleura. Through the minithoracotomy wound, the blood clot could be removed quickly and easily and the ruptured visceral blebs were excised by using the Endo GIA 45 stapler. In the succeeding 6 months to 3 years no relapses occurred. Conclusions: Spontaneous hemopneumothorax is usually treated as an urgent surgical condition. VATS+MT is an easy accessible and safe procedure that could be applied as an initial treatment method in the patient with spontaneous hemopneumothorax, especially in the treatment of the patients with active hemorrhage and massive blood clot in the thorax.
延伸閱讀
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