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  • Title: Curative Effect Observation and Prognosis Analysis of Video-Assisted Thoracic Surgery and Thoracotomy in Patients with Hemopneumothorax.
    Author: Zhang H, Yang Q, Liu T, Liu Y.
    Journal: Evid Based Complement Alternat Med; 2021; 2021():3937420. PubMed ID: 34697546.
    Abstract:
    Currently, the incidence of hemopneumothorax is high in China, and with the continuous improvement of modern medical standards, video-assisted thoracoscopic surgery (VATS) has gradually become the main method of clinical treatment of hemopneumothorax. The aim of this study was to investigate the minimally invasive mechanism and the clinical value of television thoracoscopy in the diagnosis and treatment of traumatic hemopneumothorax and to provide a relevant theoretical basis for the superiority of television thoracoscopy. In this study, total of 98 patients with traumatic hemopneumothorax admitted to three hospitals from January 2017 to December 2019 were selected and divided into 49 cases each in the thoracotomy group and VATS group according to the differences of the surgical method. The surgical situation such as operation time, intraoperative bleeding, and incision length, postoperative recovery such as duration of painkiller use, chest tube retention time, volume of drainage, and hospital stay, levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and other inflammatory factors at different times after admission to hospital, postoperative complications such as pulmonary infection, enveloped effusion, incisional infection, and pressureulcers, and recurrence rate at 12-month follow-up were used as the evaluation indexes to analyze the effect of different surgical treatment modalities in patients with hemopneumothorax and the impact on patient prognosis. The results showed that the operative time, intraoperative bleeding, duration of painkiller use, chest tube retention time, and hospital stay were shorter in the VATS group than in the thoracotomy group. The length of the surgical incision, volume of drainage, and inflammatory factor levels at different postoperative periods were lower in the VATS group than in the thoracotomy group. The incidence of postoperative complications was lower in both groups, and the difference was not statistically significant. The follow-up results showed that there were no recurrent cases in both groups 12 months after discharge. This indicates that VATS is an effective treatment option for hemopneumothorax, which can achieve the same exploration and treatment effect as thoracotomy, and has the advantages of less trauma, less bleeding, shorter operation time, and faster postoperative recovery compared with thoracotomy. The prognosis of patients treated by VTAS is good, which provides a new treatment route for patients who cannot tolerate thoracotomy and are poorly tolerated.
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