肺切除茎的经验性片覆盖:它有多保护? 一个单一机构的队列研究
Desiree Steimer1, Julia M Coughlin1, Elizabeth Yates2
1Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Mass.
The Journal of thoracic and cardiovascular surgery
|September 9, 2023
概括
在肺切除术后,经验性组织片减少支气管支气管 (BPF) 的发生率,特别是在右侧. 肋间肌肉板显示低BPF发病率,使它们适合右肺切除病例.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 肺部医学 肺部医学
背景情况:
- 支气管 (BPF) 是肺切除术后的一种严重并发症.
- 支气管茎的经验性组织片覆盖是预防BPF的常见做法.
研究的目的:
- 为了评估经验组织板对肺切除术后支气管 (BPF) 率的影响.
- 为了比较不同类型的片在预防BPF方面的有效性.
主要方法:
- 对383例肺切除术病例 (2001-2019) 的回顾性分析.
- 收集关于BPF发育,片类型,BPF发生时间和外科手术后死亡率的数据.
- 不同的类型和手术侧面之间的BPF率的比较.
主要成果:
- 在所有肺切除术中,BPF发生在10.4%的患者中,但除了外肺切除术外,这一比例降至6.6%.
- 右侧的BPF发病率明显更高 (90%的病例).
- 肋间肌肉板显示BPF率最低 (总体为4.5%,右侧为8.7%). 较大的片,如背和前,有更高的BPF率.
结论:
- 在所有正确的肺切除术病例中,由于BPF风险较高,建议进行经验性支气管茎覆盖.
- 肋间肌肉板在降低BPF率方面是有效的,即使是在右侧操作中.
- 由于BPF发病率低,左侧肺切除术的支气管茎覆盖可能是不必要的.
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