| Objective:To investigation the necessity of video-assisted thoracoscopic surgery pulmonary bullae resection underwent pleurodesis in patients with primary spontaneous pneumothorax.Methods:All these 148 cases were collected from single hole thoracoscopic resection of lung bullae of the First and the Second Affiliated Hospital of Dalian Medical University from June 2013 to June 2016,who were diagnosed with primary spontaneous pneumothotax and conduct postoperative follow-up work.Divided into three groups according to the different surgical methods:the pulmonary bullae wedge resection group,(group A,n=51);the pulmonary bullae wedge resection plus pleural abrasion group,(group B,n=49);the pulmonary bullae wedge resection plus erythromycin group,(group C,n=48).All data was analyzed with SPSS 18.0.Compare the difference of operative time,postoperative chest drainage volume,postoperative extubation time,postoperative hospitalization time,the use of parenteral analgesics,the recurrence rate and related complications of pneumothorax between A group and B group,A group and C group.Postoperative complication of pneumothorax including residual pleural cavity,pulmonary infection,persistent air leak more than 5 days,pulmonary atelectasis,hemothorax(drainage of fresh blood volume > 200ml/h,3 hours)and pleural encapsulated effusion.The X2 test was used for the count data expressed as absolute value(percentage).The ANOVA and two independent samples t-test were 0used for the measurement data when the data obeys normal distribution and homogeneity of variance expressed as “mean±standard deviation”.The kruskal-Wallis test and Mann-Whitney U test were used for the measurement data when the data does not obeys normal distribution expressed as “median±inter-quartile range”.P<0.05 was deemed as statistically significant.Results:The operative time,postoperative chest drainage volume,postoperative extubation time,postoperative hospitalization time,the use of parenteral analgesics of A group,B group,C group all increased in turn.The operation time of A group was significantly less than that of B group and C group(A VS.B p=0.005,A VS.C group P < 0.001).The difference of postoperative thoracic drainage volume(A VS.B p=<0.001、A VS.C p<0.001)、postoperative extubation time(A VS.B p=0.011、A VS.C p<0.001)and the postoperative hospitalization time(A VS.B p=0.042、A VS.C p<0.001)were significant between group A and group B,group A and group C.The use of parenteral analgesics of group A was significantly less than group C(A VS.C p<0.001),While there was no significant difference between group A and group B(A VS.B p=0.175).Total number of people who suffer postoperative complications of group A,group B,group C,were 7 cases(13.7%),10 cases(20.4%),14 cases(29.2%).The incidence of pleural encapsulated effusion between the group A and group C were significantly different(A VS.C P=0.035),While there was no significant difference between group A and group B(A VS.B p=0.300).The incidence of other postoperative complication of pneumothorax and the total number of people who suffer postoperative complications contrast no statistical significance(P > 0.05).In group A,group B and group C,the recurrence of pneumothorax was respectively 3(5.8%),4(8.2%)and 3(6.3%),there were no significant difference in recurrence rate between group A and group B,group A and group C(P > 0.05).Conclusions:1.Primary spontaneous pneumothorax underwent thoracoscopic wedge resection of lung bullae plus pleural abrasion or erythromycin pleurodesis method during operation did not reduce the recurrence rate of pneumothorax while the operative time,postoperative extubation time,postoperative drainage volume and postoperative hospital stay were increased significantly.2.The erythromycin group compared with simple wedge resection group showed more use of parenteral analgesics and higher incidence of pleural effusion.3.VATS pulmonary bulla resection is the treatment of young patients with PSP is simple and effective,while pleurodesis is not necessary during operation. |
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