背景:原发性自发性气胸(PSP)通常发生在瘦,高大,男性儿童和青少年。为了降低PSP的复发率,化学胸膜固定术可能对接受电视胸腔镜手术(VATS)楔形大疱切除术的患者有所帮助。术中OK-432(Picibanil)胸膜固定术预防小儿PSP复发的有效性和安全性尚不清楚。
方法:这是一项单中心的回顾性观察研究,2014年至2020年,纳入48例(8例女性)持续漏气的PSP儿科患者,平均年龄为16.3±1.1岁,接受VATS楔形大泡切除术和胸膜擦伤.20例患者接受了额外的术中OK-432胸膜固定术。患者的临床特点,手术结果,并对复发率进行分析。
结果:OK-432组手术时间更长(118.6±35.6vs.96.5±23.3min;p<0.05)和更高的术后发热比例(75.0%vs.28.5%;p=0.015)比标准组。未发现严重不良事件,两组的其他手术结果具有可比性。经过18.1±19.1个月的平均随访,与标准组相比,OK-432组的复发率较低(5%vs.28.6%;p<0.05,比值比0.13,95%置信区间:0.01-1.15),但在Kaplan-Meier曲线上没有统计学差异(log-rankp=0.105)。
结论:这是第一项研究,重点是在接受VATS的儿童和青少年中,对持续漏气的PSP术中增加OK-432胸膜固定术。作为单中心经验,它证明了低复发率和短期安全性的疗效。
方法:回顾性回顾,治疗性研究,三级。
BACKGROUND: Primary spontaneous pneumothorax (PSP) commonly occurs in lean, tall, male children and adolescents. To reduce recurrence rates of PSP, chemical pleurodesis could be helpful for patients undergoing video-assisted thoracoscopic surgery (VATS) wedge bullectomy. The efficacy and safety of intraoperative OK-432 (
Picibanil) pleurodesis on preventing the recurrence of PSP in pediatric patients remain unclear.
METHODS: It is a retrospective observational study in a single center, between 2014 and 2020, enrolled 48 (8 females) pediatric PSP patients with persistent air leakage at the mean age of 16.3 ± 1.1 years to receive VATS wedge bullectomy and pleural abrasion. Twenty patients received additional intraoperative OK-432 pleurodesis. The clinical characteristics of patients, surgical outcomes, and recurrence rates were analyzed.
RESULTS: The OK-432 group had longer operation time (118.6 ± 35.6 vs. 96.5 ± 23.3 min; p < 0.05) and higher proportion of postoperative fever (75.0% vs. 28.5%; p = 0.015) than the standard group. No serious adverse events were noted and other surgical outcomes in the two groups were comparable. After a mean follow-up period of 18.1 ± 19.1 months, the OK-432 group had a lower recurrence rate compared with the standard group (5% vs. 28.6%; p < 0.05, odds ratio 0.13, 95% confidence interval: 0.01-1.15), but it had no significant difference in statistics on the Kaplan-Meier curves (log-rank p = 0.105).
CONCLUSIONS: It was the first study that focused on the addition of intraoperative OK-432 pleurodesis for PSP with persistent air leakage in children and adolescents receiving VATS. It demonstrated the efficacy with a low recurrence rate and short-term safety as a single-center experience.
METHODS: Retrospective review, therapeutic study, Level III.