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
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