https://scholars.lib.ntu.edu.tw/handle/123456789/481011
標題: | Modified single-port non-intubated video-assisted thoracoscopic decortication in high-risk parapneumonic empyema patients | 作者: | Hsiao, Chen-Hao KE-CHENG CHEN JIN-SHING CHEN |
公開日期: | 2017 | 出版社: | Springer New York LLC | 卷: | 31 | 期: | 4 | 起(迄)頁: | 1719-1727 | 來源出版物: | Surgical Endoscopy | 摘要: | Background: Parapneumonic empyema patients with coronary artery disease and reduced left ventricular ejection fraction are risky to receive surgical decortication under general anesthesia. Non-intubated video-assisted thoracoscopy surgery is successfully performed to avoid complications of general anesthesia. We performed single-port non-intubated video-assisted flexible thoracoscopy surgery in an endoscopic center. In this study, the possible role of our modified surgery to treat fibrinopurulent stage of parapneumonic empyema with high operative risks is investigated. Methods: We retrospectively reviewed fibrinopurulent stage of parapneumonic empyema patients between July 2011 and June 2014. Thirty-three patients with coronary artery disease and reduced left ventricular ejection fraction were included in this study. One group received tube thoracostomy, and the other group received single-port non-intubated video-assisted flexible thoracoscopy surgery decortication. Patient demographics, characteristics, laboratory findings, etiology, and treatment outcomes were compared. Results: Mean age of 33 patients (24 males, 9 females) was 76.2?±?9.7?years. Twelve patients received single-port non-intubated video-assisted flexible thoracoscopy surgery decortication, and 21 patients received tube thoracostomy. Visual analog scale scores on postoperative first hour and first day were not significantly different in two groups (p value?=?0.5505 and 0.2750, respectively). Chest tube drainage days, postoperative fever subsided days, postoperative hospital days, and total length of stay were significantly short in single-port non-intubated video-assisted flexible thoracoscopy surgery decortication (p value?=?0.0027, 0.0001, 0.0009, and 0.0065, respectively). Morbidities were low, and mortality was significantly low (p value?=?0.0319) in single-port non-intubated video-assisted flexible thoracoscopy surgery decortication. Conclusions: Single-port non-intubated video-assisted flexible thoracoscopy surgery decortication may be suggested to be a method other than tube thoracostomy to deal with fibrinopurulent stage of parapneumonic empyema patients with coronary artery disease and reduced left ventricular ejection fraction. ? 2016, Springer Science+Business Media New York. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84982106577&doi=10.1007%2fs00464-016-5164-7&partnerID=40&md5=4f1c7d75e361f0b43319c16ac7183033 https://scholars.lib.ntu.edu.tw/handle/123456789/481011 |
ISSN: | 0930-2794 | DOI: | 10.1007/s00464-016-5164-7 | SDG/關鍵字: | aged; alpha hemolytic Streptococcus; Article; Charlson Comorbidity Index; chest tube; clamp; clinical article; clinical feature; Clostridium infection; Clostridium perfringens; coronary artery disease; demography; empyema; female; fever; fibrinopurulence; flexible bronchoscope; heart arrhythmia; heart left ventricle ejection fraction; hematothorax; high risk patient; human; hydrothorax; Klebsiella pneumoniae; Klebsiella pneumoniae infection; laboratory diagnosis; length of stay; lobar pneumonia; male; methicillin resistant Staphylococcus aureus; methicillin resistant Staphylococcus aureus infection; methicillin susceptible Staphylococcus aureus; morbidity; observational study; operation duration; operative blood loss; parapneumonic empyema; postoperative complication; priority journal; Pseudomonas aeruginosa; Pseudomonas infection; quality of life; respiratory failure; respiratory tract intubation; retrospective study; septic shock; Streptococcus constellatus; Streptococcus infection; suppuration; surgical infection; surgical mortality; surgical risk; thoracostomy; tracheostomy; treatment outcome; urosepsis; video assisted thoracoscopic decortication; video assisted thoracoscopic surgery; visual analog scale; complication; Empyema, Pleural; middle aged; procedures; risk; very elderly; video assisted thoracoscopic surgery; Aged; Aged, 80 and over; Coronary Artery Disease; Empyema, Pleural; Female; Humans; Male; Middle Aged; Retrospective Studies; Risk; Thoracic Surgery, Video-Assisted; Treatment Outcome |
顯示於: | 醫學系 |
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