Clinical experience of three cases of pleural empyema(a review of thoracoscopic surgery for empyema)

今回,われわれは胸腔鏡による掻爬と洗浄が奏効した膿胸の3例を経験したので文献的考察を加えて報告する.症例1,2では胸腔鏡下による癒着の剥離,洗浄にて速やかに胸痛および炎症所見は消失した.症例3では初発症状より5週間以上経過していたため,胸腔鏡下のみでの癒着剥離処置が困難であり小開胸術が追加された.深在性や多房性の膿胸に対しては,胸腔鏡下での掻爬と洗浄処置は低侵襲で安全かつ効率よく行うことができるが,その適切な時期を見極めることが重要である.

We retrospectively reviewed three cases of thoracic empyema treated by video-assisted thoracic surgery(VATS)with some literature. In case 1 and 2, thoracoscopic debridement and drainage were successfully performed, removing fibrin clots and septa from pleural surfaces. In case 3, the duration of symptoms before operation was over 5 weeks. Because of severe adhesion between lung and chest wall, he received a same thoracic surgery in which mini-thoracic incision was added. For the multiloculated or deeply-located acute thoracic empyema ineffective by percutaneous chest drainage. VATS is a less invasive, safe, and effective therapy. Timing of early surgical approach using thoracoscopy is important or critical.

胸腔鏡手術

膿胸

胸膜炎