Video-assisted Thoracoscopy versus Thoracotomy for Encapsulated Tuberculous Pleurisy: A Case Control Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUZhi-gang , CHANGWei ,  CHEYong , GUANXiao-jun , YANXiao-gang

The Second Department of Thoracic Surgery of Chest Hospital of Xinjiang Autonomous Region of PRC, Urumchi 830049, P. R. China;

Corresponding author：

Keywords：

Encapsulated tuberculous pleurisy; Video-assisted thoracoscopy; Pleurectomy

DOI：

10.7507/1007-4848.20160265

Video：

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Objective To compare the clinical efficacy of video-assisted thoracoscopy and thoracotomy for the treatment of encapsulated tuberculous pleurisy. Methods We retrospectively analyzed the clinical data of 99 patients who had underwent surgery for encapsulated tuberculous pleurisy within 3 months of disease onset in our hospital from January through December 2013. Based on the surgical mode, patients were assigned to a video-assisted thoracoscopy group, including 49 patients (35 males and 14 females, a mean age of 26.78±9.36 years), to receive video-assisted thoracoscopic pleurectomy; or a thoracotomy group, including 50 patients (31 males and 19 females, a mean age of 31.84±11.08 years), to receive conventional thoracotomic pleurectomy. The first 43 patients in the video-assisted thoracoscopy group received thoracic catheter drainage, with the drainage volume of 659.08±969.29 ml; the first 48 patients in the thoracotomy group received thoracic catheter drainage, with the drainage volume of 919.03±129.97 ml. The clinical effects were compared between the two groups. Results All the patients in the video-assisted thoracoscopy group completed thoracoscopy without conversion to thoracotomy. The surgery duration and postoperative intubation time were shorter in the video-assisted thoracoscopy group than those in the thoracotomy group (surgery duration:103.00±53.04 min vs. 127.06±51.60 min, P<0.01; postoperative intubation time 3.02±0.83 d vs. 3.94±1.25 d, P<0.01). At the end of 6 months of follow-up, the forced expiratory volume in one second (FEV_1>) was 2.83±0.64 L in the thoracos-copy group and 2.25±0.64 L in the thoracotomy group (P<0.01); forced vital capacity (FVC) was 3.02±0.72 L in the thora-coscopy group and 2.57±0.79 L in the thoracotomy group (P<0.05); and maximal voluntary ventilation (MVV) was 93.90± 15.86 L in the thoracoscopy group and 80.34±17.06 L in the thoracotomy group (P<0.01). Conclusion Thoracoscopic surgery is feasible for patients with encapsulated pleurisy within 3 months of onset. Furthermore video-assisted thoraco-scopy will be superior to thoracotomy.

Citation： LIUZhi-gang, CHANGWei, CHEYong, GUANXiao-jun, YANXiao-gang. Video-assisted Thoracoscopy versus Thoracotomy for Encapsulated Tuberculous Pleurisy: A Case Control Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(12): 1128-1131. doi: 10.7507/1007-4848.20160265 Copy

1.	中国防痨协会临床专业委员会.结核病临床诊治进展年度报告(2012年) (第一部分结核病临床诊断). 中国防痨杂志, 2013, 35(6): 405-426.
2.	Marks DJ, Fisk MD,Koo CY, et al. Thoracic empyema: a 12-year study from a UK tertiary cardiothoracic referral centre. PLoS One, 2012, 7(1): e30074.
3.	金明华，王伟，王传庆, 等. 电视胸腔镜脓胸廓清术治疗结核性脓胸. 中国微创外科杂志, 2012, 6: 524-526.
4.	Yang HC, Han J, Lee S, et al. Evaluation of decortication in patients with chronic tuberculous empyema by three-dimensional computed tomography densitometry. Thorac Cardiovasc Surg, 2013, 61(2): 159-166.
5.	朱成楚, 叶加洪, 叶中瑞, 等. 电视胸腔镜下胸膜纤维板剥脱术治疗脓胸及包裹性胸腔积液. 中华胸心血管外科杂志, 1998, 14(4): 13-14.
6.	廖勇, 韦鸣, 许建荣, 等. 电视胸腔镜治疗胸部结核病变的临床分析. 广西医学, 2012, 34(5): 572-574.
7.	吴德文, 文凯, 任天顺, 等. 电视胸腔镜手术治疗胸部疾病8例. 陕西医学杂志, 2005, 34(2): 185-187.
8.	Yim AP. The role of video-assisted thoracoscopic surgery in the management of pulmonary tuberculosis. Chest, 1996, 110(3): 829-832.
9.	Kerti CA, Miron I, Cozma GV, et al. The role of surgery in the mana-gement of pleuropulmonary tuberculosis-seven years' experience at a single institution. Interact Cardiovasc Thorac Surg, 2009, 8(3): 334-337.
10.	Kang MW, Kim HK, Choi YS. et al. Surgical treatment for multidrug-resistant and extensive drug-resistant tuberculosis. Ann Thorac Surg, 2010, 89(5): 1597-1602.
11.	Yen YT, Wu MH, Lai WW, et al. The role of video-assisted thoraco-scopic surgery in therapeutic lung resection for pulmonary tubercu-losis. Ann Thorac Surg, 2013, 95(1): 257-263.
12.	车勇, 刘志刚, 常炜, 等. 全胸腔镜肺叶切除治疗继发性肺结核38例临床分析. 新疆医学, 2013, 43(4): 66-68.
13.	施伟, 王浩, 吴佩卿, 等. 电视胸腔镜外科治疗脓胸36例分析. 浙江医学, 2007, 29(12): 1317-1318.
14.	Petrakis IE, Kogerakis NE, Drositis IE, et al. Video-assisted thoraco-scopic surgery for thoracic empyema: primarily, or after fibrinolytic therapy failure? Am J Surg, 2004, 187(4): 471-474.
15.	Scarci M, Abah U, Soli P, et al. EACTS expert consensus statement for surgical management of pleural empyema. Eur J Cardiothorac Surg, 2015, 48(5): 642-653.
16.	Wurnig PN, Wittmer V, Pridun NS. et al. Video-assisted thoracic surgery for pleural empyema. Ann Thorac Surg, 2006, 81(1): 309-313.
17.	骆学全, 张波, 张文, 等. 电视胸腔镜全胸膜剥脱术在胸外科方面的临床应用. 中国内镜杂志, 2003, 9(6): 88-90.
18.	Chan DT, Sihoe AD, Chan S, et al. Surgical treatment for empyema thoracis: is video-assisted thoracic surgery "better" than thoracotomy? Ann Thorac Surg, 200, 84(1): 225-231.
19.	Drain AJ, Ferguson JI, Sayeed R, et al. Definitive management of advanced empyema by two-window video-assisted surgery. Asian Cardiovasc Thorac Ann, 2007, 15(3): 238-239.
20.	车勇, 戴卫平, 周旭东, 等. 包裹性胸膜炎手术前后肺功能研究分析. 新疆医学, 2004, 34(4): 25-26.
21.	陈丽, 陈勇, 张海燕, 等. 110例包裹性结核性胸膜炎手术后分析. 吉林医学, 2009, 30(13): 1357-1358.

1. 中国防痨协会临床专业委员会.结核病临床诊治进展年度报告(2012年) (第一部分结核病临床诊断). 中国防痨杂志, 2013, 35(6): 405-426.
2. Marks DJ, Fisk MD,Koo CY, et al. Thoracic empyema: a 12-year study from a UK tertiary cardiothoracic referral centre. PLoS One, 2012, 7(1): e30074.
3. 金明华，王伟，王传庆, 等. 电视胸腔镜脓胸廓清术治疗结核性脓胸. 中国微创外科杂志, 2012, 6: 524-526.
4. Yang HC, Han J, Lee S, et al. Evaluation of decortication in patients with chronic tuberculous empyema by three-dimensional computed tomography densitometry. Thorac Cardiovasc Surg, 2013, 61(2): 159-166.
5. 朱成楚, 叶加洪, 叶中瑞, 等. 电视胸腔镜下胸膜纤维板剥脱术治疗脓胸及包裹性胸腔积液. 中华胸心血管外科杂志, 1998, 14(4): 13-14.
6. 廖勇, 韦鸣, 许建荣, 等. 电视胸腔镜治疗胸部结核病变的临床分析. 广西医学, 2012, 34(5): 572-574.
7. 吴德文, 文凯, 任天顺, 等. 电视胸腔镜手术治疗胸部疾病8例. 陕西医学杂志, 2005, 34(2): 185-187.
8. Yim AP. The role of video-assisted thoracoscopic surgery in the management of pulmonary tuberculosis. Chest, 1996, 110(3): 829-832.
9. Kerti CA, Miron I, Cozma GV, et al. The role of surgery in the mana-gement of pleuropulmonary tuberculosis-seven years' experience at a single institution. Interact Cardiovasc Thorac Surg, 2009, 8(3): 334-337.
10. Kang MW, Kim HK, Choi YS. et al. Surgical treatment for multidrug-resistant and extensive drug-resistant tuberculosis. Ann Thorac Surg, 2010, 89(5): 1597-1602.
11. Yen YT, Wu MH, Lai WW, et al. The role of video-assisted thoraco-scopic surgery in therapeutic lung resection for pulmonary tubercu-losis. Ann Thorac Surg, 2013, 95(1): 257-263.
12. 车勇, 刘志刚, 常炜, 等. 全胸腔镜肺叶切除治疗继发性肺结核38例临床分析. 新疆医学, 2013, 43(4): 66-68.
13. 施伟, 王浩, 吴佩卿, 等. 电视胸腔镜外科治疗脓胸36例分析. 浙江医学, 2007, 29(12): 1317-1318.
14. Petrakis IE, Kogerakis NE, Drositis IE, et al. Video-assisted thoraco-scopic surgery for thoracic empyema: primarily, or after fibrinolytic therapy failure? Am J Surg, 2004, 187(4): 471-474.
15. Scarci M, Abah U, Soli P, et al. EACTS expert consensus statement for surgical management of pleural empyema. Eur J Cardiothorac Surg, 2015, 48(5): 642-653.
16. Wurnig PN, Wittmer V, Pridun NS. et al. Video-assisted thoracic surgery for pleural empyema. Ann Thorac Surg, 2006, 81(1): 309-313.
17. 骆学全, 张波, 张文, 等. 电视胸腔镜全胸膜剥脱术在胸外科方面的临床应用. 中国内镜杂志, 2003, 9(6): 88-90.
18. Chan DT, Sihoe AD, Chan S, et al. Surgical treatment for empyema thoracis: is video-assisted thoracic surgery "better" than thoracotomy? Ann Thorac Surg, 200, 84(1): 225-231.
19. Drain AJ, Ferguson JI, Sayeed R, et al. Definitive management of advanced empyema by two-window video-assisted surgery. Asian Cardiovasc Thorac Ann, 2007, 15(3): 238-239.
20. 车勇, 戴卫平, 周旭东, 等. 包裹性胸膜炎手术前后肺功能研究分析. 新疆医学, 2004, 34(4): 25-26.
21. 陈丽, 陈勇, 张海燕, 等. 110例包裹性结核性胸膜炎手术后分析. 吉林医学, 2009, 30(13): 1357-1358.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Video-assisted Thoracoscopy versus Thoracotomy for Encapsulated Tuberculous Pleurisy: A Case Control Study

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