PENG Haijun, LUAN Yanchao, QIN Xuebo, LI Yishuai, ZHANG Lei. Efficacy of thoracoscopic pulmonary bulla resection in treating giant emphysematous bulla complicated with moderate to severe pulmonary hypofunction[J]. Journal of Clinical Medicine in Practice, 2023, 27(12): 93-97, 104. DOI: 10.7619/jcmp.20231098
Citation: PENG Haijun, LUAN Yanchao, QIN Xuebo, LI Yishuai, ZHANG Lei. Efficacy of thoracoscopic pulmonary bulla resection in treating giant emphysematous bulla complicated with moderate to severe pulmonary hypofunction[J]. Journal of Clinical Medicine in Practice, 2023, 27(12): 93-97, 104. DOI: 10.7619/jcmp.20231098

Efficacy of thoracoscopic pulmonary bulla resection in treating giant emphysematous bulla complicated with moderate to severe pulmonary hypofunction

More Information
  • Received Date: April 06, 2023
  • Revised Date: June 08, 2023
  • Available Online: July 07, 2023
  • Objective 

    To observe the clinical effects of single- and double-port thoracoscopic pulmonary bulla (PB) resection in the treatment of giant emphysematous bulla (GEB) patients with moderate to severe pulmonary hypofunction.

    Methods 

    A total of 92 GEB patients with moderate to severe pulmonary hypofunction were randomly divided into study group with 46 cases (treated with single-port thoracoscopic PB resection) and control group with 46 cases (treated with double-port thoracoscopic PB resection). Surgical condition, postoperative recovery, pulmonary function indexes [forced expiratory volume in the first second as a percentage (FEV1%), maximal ventilatory volume as a percentage (MVV%)], arterial blood gas indexes {arterial partial pressure of oxygen [pa(O2)], arterial partial pressure of carbon dioxide [pa(CO2)]}, serum inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6)], transforming growth factor β receptor 1 (TβR1), fibroblast growth factor-10 (FGF-10), 6 minutes walking distance (6 MWD), St. George′s Respiratory Questionnaire (SGRQ) score, incidence of complications and recurrence rate were compared between two groups.

    Results 

    The bleeding volume and thoracic drainage volume in the study group were significantly less than those in the control group, and the postoperative catheterization time and hospital stay were significantly shorter than those in the control group (P < 0.05); the serum levels of CRP, IL-6, TβR1 and FGF-10 in the study group were significantly lower than those in the control group at 1 week after operation (P < 0.05); the FEV1%, MVV% and pa(O2) in both groups at 6 months after operation were significantly higher than those before operation, while pa(CO2) was significantly lower than that before operation (P < 0.05); the 6 MWD and SGRQ score at 6 months after operation in both groups were significantly higher than those before operation (P < 0.05); the incidence of complications in the study group was 8.70%, which was significantly lower than 23.91% in the control group (P < 0.05); there was no case with recurrence of PB in both groups after re-examination of chest CT on the operation side within 12 months after operation.

    Conclusion 

    For GEB patients with moderate to severe pulmonary hypofunction, thoracoscopic PB resection can significantly improve patient's lung function and quality of life. Single-port thoracoscopic surgery can further alleviate surgical trauma, and reduce the incidence of complications and promote postoperative recovery.

  • [1]
    林志忠, 余伟, 庹哲, 等. 胸腔镜辅助小切口手术与传统开胸手术治疗肺大疱并自发性气胸患者的效果比较[J]. 实用临床医药杂志, 2020, 24(1): 88-91. doi: 10.7619/jc
    [2]
    ARAMINI B, RUGGIERO C, STEFANI A, et al. Giant bulla or pneumothorax: how to distinguish[J]. Int J Surg Case Rep, 2019, 62: 21-23. doi: 10.1016/j.ijscr.2019.08.003
    [3]
    张华, 王蕾, 葛长胜, 等. 经内科胸腔镜行巨型肺大泡减容术的疗效及安全性研究[J]. 中华医学杂志, 2021, 101(30): 2370-2374. doi: 10.3760/cma.j.cn112137-20201116-03107
    [4]
    ZHU C C, CHEN Z X, CHEN B F, et al. Thoracoscopic treatment of giant pulmonary bullae[J]. J Surg Res, 2019, 243: 206-212. doi: 10.1016/j.jss.2019.05.009
    [5]
    BUERO A, NARDI W S, LYONS G A, et al. Entirely thoracoscopic resection of a giant emphysematous bulla[J]. Pan Afr Med J, 2018, 30: 247.
    [6]
    胡杰伟, 钟钏, 杨绪全. 胸腔镜治疗合并复杂情况的巨大肺大疱32例报告[J]. 中国微创外科杂志, 2018, 18(6): 503-504, 516. doi: 10.3969/j.issn.1009-6604.2018.06.007
    [7]
    LO C, LIANG W M, HANG L W, et al. A psychometric assessment of the St. George′s respiratory questionnaire in patients with COPD using Rasch model analysis[J]. Health Qual Life Outcomes, 2015, 13: 131. doi: 10.1186/s12955-015-0320-7
    [8]
    LESCHBER G. Video-assisted thoracic surgery: a global development[J]. Chirurg, 2018, 89(3): 185-190. doi: 10.1007/s00104-018-0592-7
    [9]
    QAQISH T R, COX S, CARR R, et al. Treatment of pleural effusions with nonintubated video-assisted thoracoscopic surgery[J]. Thorac Surg Clin, 2020, 30(1): 25-32. doi: 10.1016/j.thorsurg.2019.08.003
    [10]
    杜东海, 秦合军, 谷凡, 等. 单孔胸腔镜肺大疱切除术治疗肺大疱伴自发性气胸的疗效研究[J]. 微创医学, 2021, 16(5): 655-657. https://www.cnki.com.cn/Article/CJFDTOTAL-WCYX202105020.htm
    [11]
    禹德富, 梁璃汇, 黄圣杰. 经剑突下入路和经肋间入路单孔胸腔镜肺大疱切除术的临床疗效对比[J]. 局解手术学杂志, 2022, 31(1): 48-51. https://www.cnki.com.cn/Article/CJFDTOTAL-JJXZ202201011.htm
    [12]
    冯喆, 高继东, 郑明非, 等. 电视胸腔镜不同操作法治疗老年自发性气胸合并肺大疱的疗效及对炎性因子的影响[J]. 国际老年医学杂志, 2022, 43(3): 273-277. https://www.cnki.com.cn/Article/CJFDTOTAL-GWLL202203005.htm
    [13]
    ZHANG T, JIANG H, MING C Y, et al. Influence of different kinds of surgical resection on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer[J]. Pak J Med Sci, 2020, 36(3): 532-537.
    [14]
    ZHAI B, ZHANG Y H, CHEN Z L, et al. Effect of video assisted thoracoscopic surgery on pain stress indicators NO, IL-1β and IL-6 in the treatment of mediastinal tumor in children[J]. Oncol Lett, 2020, 19(6): 3931-3936.
    [15]
    WANG X Y, YOU B, CHEN S, et al. Expression of TGF-beta receptor 1 and Smads in the tissues of primary spontaneous pneumothorax[J]. J Thorac Dis, 2018, 10(3): 1765-1774. doi: 10.21037/jtd.2018.03.10
    [16]
    杨罡, 王争君, 朱琳燕, 等. 急性自发性气胸患者肺大疱中细胞因子的表达及其意义[J]. 中国临床研究, 2016, 29(6): 737-740. doi: 10.13429/j.cnki.cjcr.2016.06.005
    [17]
    FENG Y, WANG L L, MA X Y, et al. Effect of hCMSCs and liraglutide combination in ALI through cAMP/PKAc/β-catenin signaling pathway[J]. Stem Cell Res Ther, 2020, 11(1): 2. doi: 10.1186/s13287-019-1492-6
    [18]
    陈健, 杨莉, 金杰, 等. CT引导下胸腔引流微管对肺气肿合并巨大肺大疱患者的疗效及安全性[J]. 实用医学杂志, 2022, 38(9): 1125-1129. doi: 10.3969/j.issn.1006-5725.2022.09.015
  • Related Articles

    [1]HOU Bingbing, MA Yin, WANG Wei, YANG Xiaoxin, GAO Yan. Application effect of multidisciplinary collaborative nursing based on the Information-Knowledge-Attitude-Practice theory in patients undergoing lobectomy via thoracoscopy[J]. Journal of Clinical Medicine in Practice, 2025, 29(3): 89-93. DOI: 10.7619/jcmp.20245219
    [2]LU Yanfeng, DAI Jiabao, WU Zhouquan, ZOU Zhiqing. Effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection[J]. Journal of Clinical Medicine in Practice, 2024, 28(9): 90-94. DOI: 10.7619/jcmp.20234042
    [3]WEI Xinqi, RUAN Aichao, YANG Ying, ZHANG Qing. Clinical nursing pathway management in patients with CT-guided thoracoscopic small pulmonary nodules resection[J]. Journal of Clinical Medicine in Practice, 2022, 26(18): 120-123. DOI: 10.7619/jcmp.20221144
    [4]Palidan·NIYAZI, Yisilamujiang·TUERXUN, WANG Shanshan. Application value of Hook-wire localization under CT guidance before thoracoscopic resection of small pulmonary ground-glass nodules[J]. Journal of Clinical Medicine in Practice, 2022, 26(15): 36-39, 44. DOI: 10.7619/jcmp.20221137
    [5]WANG Jianping, GAO Jie, XUE Hengchuan, MA Zhenkai, ZHU Zonghai, ZHAO Mengmeng. Thoracoscopic pulmonary segmentectomy versus lobectomy in the treatment of early non-small cell lung cancer in elderly patients[J]. Journal of Clinical Medicine in Practice, 2020, 24(11): 97-100. DOI: 10.7619/jcmp.202011026
    [6]LIN Zhizhong, YU Wei, TUO Zhe, HU Xiuhua. Thoracoscope-assisted small incision surgery versus traditional thoracotomy in the treatment of pulmonary bulla patients complicated with spontaneous pneumothorax[J]. Journal of Clinical Medicine in Practice, 2020, 24(1): 88-91. DOI: 10.7619/jcmp.202001022
    [7]XU Yi, CUI Fengxian, ZHANG Shaofen, GUO Jun, PENG Jun. Analysis of fast comprehensive rehabilitation care for single hole thoracoscopic pulmonary lobectomy in patients in perioperation[J]. Journal of Clinical Medicine in Practice, 2017, (14): 75-77. DOI: 10.7619/jcmp.201714022
    [8]ZHENG Congchong, YU Tongfu, LIU Xisheng, CHEN Liang, ZHU Quan, XU Hai, ZHANG Wei. Application of preoperative CT-guided Hookwire and methylxanthine chloride in treatment of small pulmonary nodule patients with thoracoscopy[J]. Journal of Clinical Medicine in Practice, 2014, (3): 33-35. DOI: 10.7619/jcmp.201403010
    [9]Lu Ye, Cheng Hui, Chen Yong. Perioperative nursing for patients with thoracoscopic resection of lung bullae[J]. Journal of Clinical Medicine in Practice, 2012, (22): 166-167,172.
    [10]ZHANG Qing-hai, HUANG Li-li, WANG Xin. Postoperative analgesia effect of propacetamol on pulmonary bulla resection by thoracoscopy[J]. Journal of Clinical Medicine in Practice, 2012, (17): 119-120,123.
  • Cited by

    Periodical cited type(35)

    1. 卢新阳,孙奕舒,徐涛,范龙彬,常雅宁,周英骏. 玫瑰蜂花粉破壁工艺优化及其醇提物生理活性比较. 食品工业科技. 2025(04): 176-184 .
    2. 彭展. 前列舒通胶囊联合坦索罗辛治疗轻度良性前列腺增生患者的效果. 中国民康医学. 2024(05): 106-109 .
    3. 马嘉,邢建月,张宇鹏,刘光珍. 中成药治疗良性前列腺增生有效性和安全性的贝叶斯网状Meta分析. 药物流行病学杂志. 2024(03): 301-318 .
    4. 凡丽丽,任贤,赵会云. 腕踝针镇痛对老年患者经尿道前列腺等离子电切术后膀胱痉挛及康复效果的影响. 深圳中西医结合杂志. 2024(07): 46-48 .
    5. 王红慧,姚华婧,王本鹏. 基于网络药理学及分子对接探讨灵泽片治疗前列腺良性增生的作用机制. 中医临床研究. 2024(20): 7-14 .
    6. 张秋燕,张恋. 基于加速康复外科理念的护理在良性前列腺增生患者围手术期中的应用效果分析. 延边大学医学学报. 2024(05): 652-655 .
    7. 赵锦燕,王雪皎,李斐,林久茂,周建衡. 前列宁调控基质金属蛋白酶降解胶原蛋白对前列腺增生治疗的影响. 世界中医药. 2024(22): 3467-3472+3478 .
    8. 张文武,梁美丹,李峰. 中西医结合治疗良性前列腺增生研究进展. 辽宁中医药大学学报. 2023(01): 216-220 .
    9. 米嘉希,陈慧,曹璐,朱冠辰. 基于加速康复外科理念的护理在良性前列腺增生患者围术期中的应用. 护理实践与研究. 2023(01): 6-10 .
    10. 黄瑜,蔡润东,李军. 小蓟饮子治疗良性前列腺增生患者经尿道前列腺切除术后出血的疗效. 中国民间疗法. 2023(03): 60-63 .
    11. 杨硕,谢雁鸣,王连心,孙粼希. 夏荔芪胶囊治疗前列腺增生(本虚标实证)的临床综合评价. 中草药. 2023(09): 2879-2888 .
    12. 张志忠. 前列腺汽化电切术治疗前列腺增生合并慢性前列腺炎的效果及其对炎症因子、尿动力学的影响. 黑龙江医学. 2023(08): 925-928 .
    13. 朱媛媛,边利萍. 手术室预见性干预结合舒适性护理对前列腺增生手术患者压力性损伤及应激反应的影响. 临床医学研究与实践. 2023(13): 150-152 .
    14. 曹艳敏,梁敬哲,李馨悦,王丹妮,董梦薇,何立. 督脉药饼灸法治疗肾虚血瘀型良性前列腺增生的临床研究. 河北中医药学报. 2023(03): 25-28+34 .
    15. 吴崇才,林鸿彪. PKURP术联合同期行TEP对老年前列腺增生合并腹股沟疝治疗的效果. 中国老年学杂志. 2023(13): 3152-3155 .
    16. 贾玉聪,张辉,张凯波,樊立鹏,陈翔,郝高利,付晓君. 针刺联合益肾通络督脉灸治疗良性前列腺增生. 中医学报. 2023(08): 1783-1787 .
    17. 梁博,商学军,裴丽君. 中国中老年男性人群患慢性疾病与可能肌少症发生风险关联的队列研究. 中华男科学杂志. 2023(01): 10-18 .
    18. 于楠楠,刘征,匡禹霏,韩亚鹏,薛剑,李禹洋,孙殿甲. 热敏灸结合芒针透刺对良性前列腺增生症尿动力学、血中激素及PSA水平影响的临床研究. 针灸临床杂志. 2023(08): 38-42 .
    19. 王鹏,熊伟,龙衍,周青. 周青基于“肺为水之上源”论治男性下尿路症状经验. 中医药导报. 2023(08): 193-197 .
    20. 杨周,李健,陈治宇,张文雯,胡霞,于朝春. 五苓散在膀胱功能障碍相关疾病中的临床应用进展. 世界中西医结合杂志. 2023(08): 1692-1696 .
    21. 尹晓艳,习小燕,周晓兰. 综合性护理应用于前列腺电切术病人的效果评价. 现代诊断与治疗. 2023(13): 2029-2031 .
    22. 周建衡,赵锦燕,王雪皎,李斐,林久茂. 前列宁通过调控前列腺MMP-2、TIMP-2降解层粘连蛋白治疗良性前列腺增生的机制研究. 福建中医药. 2023(09): 51-55 .
    23. 李风. 六味南术汤治疗前列腺增生症临床观察. 中国中医药现代远程教育. 2023(24): 97-99 .
    24. 韩亮,王彬,张新荣,彭爱进,杨勇,李海松,张霄潇. 良性前列腺增生实验模型述评. 中国实验方剂学杂志. 2022(02): 227-235 .
    25. 孙粼希,吕健,谢雁鸣. 夏荔芪胶囊治疗良性前列腺增生的有效性和安全性的Meta分析. 中药新药与临床药理. 2022(02): 265-272 .
    26. 朱文雄,袁轶峰,彭涛,张熙,刘涛,李博,陈其华. 益气活血消癥方干预TFF/Wnt信号通路治疗前列腺增生的研究. 北京中医药大学学报. 2022(02): 193-200 .
    27. 张强,杨晓亮,杨晓波,师宏斌,赵瑞宁,张超. CD71与E-cadherin在丙酸睾酮诱导的前列腺组织中的表达. 宁夏医学杂志. 2022(04): 319-321+385 .
    28. 于国盛,杨波,王成达,郝战宽. 两种手术方式治疗大体积良性前列腺增生症效果比较. 中国实用乡村医生杂志. 2022(04): 47-49+53 .
    29. 马允,侯冰燕,张志,刘颖,王文地,侯俊玲,王文全. 不同龄SD大鼠自发性良性前列腺增生的研究. 西北药学杂志. 2022(03): 112-116 .
    30. 张凯波,李桓,王锁刚. 基于网络药理学及分子对接技术研究五苓散治疗前列腺增生的作用机制. 中医学报. 2022(08): 1727-1733 .
    31. 刘尧,赵永哲,赵伟,贺迎雪,李乘龙,张雷,冯士楼. 经尿道前列腺钬激光剜除术对良性前列腺增生患者的影响. 中外医学研究. 2022(20): 33-38 .
    32. 项效益. 前列腺动脉栓塞术联合经尿道前列腺电切术治疗体积>80 ml良性前列腺增生的短中期随访研究. 临床医学. 2022(09): 22-25 .
    33. 王皓,冯岳龙,杨玲,张强,高裕,李培军. ALDH2在丙酸睾酮诱导的前列腺组织中的表达. 宁夏医学杂志. 2022(11): 968-969+956 .
    34. 王琳琳,许丽丽,范君,钱余. 氧化应激标志物与前列腺增生和前列腺癌的相关性. 检验医学. 2022(12): 1135-1140 .
    35. 郝梦,米尔扎提·麦麦提,马璇,张明惠,季志红. 基于网络药理学和分子对接探讨西帕依麦孜彼子口服液抗良性前列腺增生的作用机制. 中国药师. 2021(12): 2148-2153+2166 .

    Other cited types(20)

Catalog

    Article views (99) PDF downloads (2) Cited by(55)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return