Analysis of effect of video-assisted thoracoscopic surgery versus thoracotomy in the treatment of refractory cavity pulmonary tuberculosis

doi:10.19983/j.issn.2096-8493.20220029

Abstract

Abstract:

Objective: To analyze the clinical efficacy of video-assisted thoracoscopic surgery (VATS) and thoracotomy in the treatment of refractory cavitary pulmonary tuberculosis. Methods: The clinical data of 60 refractory cavitary pulmonary tuberculosis patients who met the inclusion criteria and underwent thoracic surgery from January 2011 to January 2020 were retrospectively analyzed, of which 42 underwent VATS (the VATS group) and 18 underwent thoracotomy (the thoracotomy group), all of them underwent lobectomy or wedge resection. The operation time, intraoperative blood loss, postoperative catheterization time, postoperative hospital stay, wound infection rate and the progress of tuberculosis were compared between the two groups to evaluate the clinical effect of the two surgical methods. Results: There were no significant differences in operative time ((130.2±43.5) min vs. (110.6±40.3) min, t=1.293, P=0.203) and postoperative incision infection (2.4% (1/42) vs. 16.7% (3/18), χ²=4.133, P=0.077) between the VATS group and the thoracotomy group. The intraoperative blood loss, postoperative catheter time, postoperative hospital stay in the VATS group were significantly lower than the thoracotomy group ((213.5±20.7) ml vs. (360.3±82.6) ml, t=-11.112; (6.4±1.2) d vs. (8.8±1.5) d, t=-6.503; (9.4±1.2) d vs. (12.8±1.4) d, t=-9.281; all P<0.001). Three patients in the thoracotomy group suffered persistent air leakage after operation, and all of them recovered after symptomatic treatment. All the 60 patients were followed up for 24 months, without tuberculosis recurrence or serious complications. Conclusion: Video-assisted thoracoscopic surgery for refractory cavitary pulmonary tuberculosis is a safe and effective method, compared with the thoracotomy, the surgical trauma is less, the bleeding is less, the recovery is faster, and there is no increasement in perioperative deaths and complications.

Key words: Tuberculosis, pulmonary, Thoracoscopy, thoracic surgery, Comparative study, Treatment outcome

CLC Number:

Li Yishuai, Qin Xuebo, Li Xianglan, Wei Lan, Duan Xiaoliang, Zhang Lei, Chen Liang, Li Jianhang. Analysis of effect of video-assisted thoracoscopic surgery versus thoracotomy in the treatment of refractory cavity pulmonary tuberculosis[J]. Journal of Tuberculosis and Lung Disease , 2022, 3(4): 292-295. doi: 10.19983/j.issn.2096-8493.20220029

Figures/Tables 1

组别	手术时间 (min, $x ¯$ ±s)	术中出血量 (ml, $x ¯$ ±s)	术后带管时间 (d, $x ¯$ ±s)	住院时间 (d, $x ¯$ ±s)	切口感染 [例(发生率,%)]	结核进展 [例(发生率,%)]
VATS组(42例)	130.2±43.5	213.5±20.7	6.4±1.2	9.4±1.2	1(2.4)	1(2.4)
开胸组(18例)	110.6±40.3	360.3±82.6	8.8±1.5	12.8±1.4	3(16.7)	0(0.0)
统计检验值	t=1.293	t=-11.112	t=-6.503	t=-9.281	χ²=4.133	χ²=0.436
P值	0.203	<0.001	<0.001	<0.001	0.077	1.000

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