Comparative studies using a rigid thoracoscope and fiberoptic bronchoscope to treat spontaneous pneumothorax
Autor: | Tohru Satoh, Masakt Nagasawa, Keiko Yamada, Tomei Tsukamoto, Hidenori Nakamura |
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Rok vydání: | 1991 |
Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine Electrocoagulation Rigid thoracoscope medicine Thoracoscopes Fiber Optic Technology Humans Thoracotomy medicine.diagnostic_test business.industry Respiratory disease Pneumothorax medicine.disease Endoscopy Surgery Bronchoscopes Fiberoptic bronchoscope Drainage Female Cardiology and Cardiovascular Medicine business |
Zdroj: | Chest. 100(4) |
ISSN: | 0012-3692 |
Popis: | Prior to 1978, the conventional treatment of pneumothorax generally consisted of conservative therapies such as rest, needle puncture, or thoracic cavity drainage; however, when conservative therapies were ineffective or relapse occurred, a thoracotomy was performed. Using a conventional therapeutic approach, 34 percent (11/32) of our patients required a thoracotomy. Consequently, in 1981, we began to use alternative therapies to reduce the need for thoracotomy. In this report, we describe the results of using a rigid thoracoscope and fiberoptic bronchoscope for the treatment of spontaneous pneumothorax. Initially, we treated 31 of 79 patients with a rigid thoracoscope and electrocoagulation therapy. Therapy was effective in 17 (55 percent) of the patients. Only 13 (16 percent) of the 79 patients required a thoracotomy, which represents a 50 percent reduction in incidence. Of the 14 cases in which therapy was ineffective, the major cause of failure was our inability to view a broad thoracic area and treat all blebs with a rigid thoracoscope. Subsequently, we developed a method using a fiberoptic bronchoscope (FB), which allows an unrestricted view of the thoracic area, in combination with electrocoagulation and fibrinogen or thrombin solution (or both) for the treatment of spontaneous pneumothorax. We treated 19 of 39 patients with the FB method. Treatment was effective in 15 (80 percent) of the patients. Only 4 (10 percent) of the 39 patients required a thoracotomy, which is a reduction of over 00 percent in our original incidence. |
Databáze: | OpenAIRE |
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