PDF(Pubmed)
Abstract：
Postoperative pneumothorax is a well-known but relatively rare complication after laparoscopic surgery. Herein, we report a case of persistent pneumothorax after laparoscopic appendectomy. A 57-year-old male, with a history of minimally invasive esophagectomy and intrathoracic gastric tube reconstruction 5 years before, underwent a laparoscopic appendectomy. A chest X-ray taken on postoperative Day 1 revealed the development of the right pneumothorax, which took more than 3 days to resolve spontaneously. Although the mechanism of postoperative pneumothorax was unclear, it seemed likely that the air that had replaced carbon dioxide in the peritoneal cavity migrated into the thoracic cavity through the esophageal hiatus, which was not covered by the peritoneum or pleura after surgical resection. The present case, together with our previous similar case, suggests that a history of esophageal cancer surgery per se increases the risk of pneumothorax after laparoscopic surgery, probably regardless of when this was performed.
摘要：
术后气胸是腹腔镜手术后众所周知但相对罕见的并发症。在这里，我们报告一例腹腔镜阑尾切除术后持续性气胸。一个57岁的男性,5年前有微创食管切除和胸内胃管重建术史，接受了腹腔镜阑尾切除术。术后第1天的胸部X线检查显示右侧气胸的发展，这需要超过3天的时间才能自发解决。虽然术后气胸的发病机制尚不清楚,似乎取代了腹膜腔中二氧化碳的空气通过食管裂孔迁移到胸腔中，手术切除后未被腹膜或胸膜覆盖。本案,再加上我们之前的类似案例,表明食管癌手术史本身会增加腹腔镜手术后气胸的风险，可能不管这是什么时候进行的。
