Analysis of diagnosis and treatment of 76 cases of chronic tuberculous empyema treated by complete thoracoscopy with process optimization method

doi:10.19983/j.issn.2096-8493.20230063

Abstract

Abstract:

Objective: To explore the feasibility of the process optimization method in the treatment of chronic tuberculous empyema under complete thoracoscopy. Methods: The data of 76 patients with chronic tuberculous empyema who underwent complete thoracoscopic surgery with procedure optimization method in the Fourth Hospital in Chaoyang City from April 2015 to February 2019 were retrospectively analyzed. The process optimization methods mainly include changing the incision design sequence of thoracoscopic surgery, improving the technology of thoracoscopic operation space establishment, unifying the sequence of fiberboard stripping, and unique thoracic drainage tube placement. The evaluation time of long-term efficacy was based on the time of 9-12 months of standardized anti-tuberculosis drug treatment after surgery. Results: Video-assisted thoracoscopic surgery was successfully completed in all 76 patients, and a total of 77 surgeries were performed, among which 1 patient with bilateral chronic tuberculous empyema underwent staging surgery without conversion to thoracotomy. The operation lasted 60 to 260 minutes, with the median of 120 (90, 160) minutes, and the intraoperative bleeding was 150 to 2000 ml, with the median of 700 (540, 800) ml. Drainage tube indwelling time was 4-22 days (median, 7 (6, 11) days). Postoperative hospitalization lasted 6 to 26 days (median, 8 (7, 13) days). The incidence of postoperative complications was 19.5% (15/77), including delayed incision healing in 6 cases, persistent lung leakage in 8 cases and chylothorax in 1 case. Postoperative follow-up was 9 to 55 months (median, 26 (20, 37) months), no cases recurrence or underwent second operation. The long-term outcome was evaluated: 88.2% (67/76) achieved grade Ⅰ, 9.2% (7/76) achieved grade Ⅱ, and 2.6% (2/76) achieved grade Ⅲ. Conclusion: The long-term effect of complete video-assisted thoracoscopic surgery used to treat chronic tuberculous empyema by process optimization method is good. For patients with surgical indications, it is worth promoting.

Key words: Thoracic surgery, video-assisted, Empyema, tuberculous, Surgical procedures, minimally invasive, Treatment outcome

CLC Number:

Zhang Ying, Lao Haijun, Lin Bing, Liu Junting, Sun Dongmei. Analysis of diagnosis and treatment of 76 cases of chronic tuberculous empyema treated by complete thoracoscopy with process optimization method[J]. Journal of Tuberculosis and Lung Disease , 2023, 4(4): 308-312. doi: 10.19983/j.issn.2096-8493.20230063

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