Comparation of the Effects of Thoracoscopic Total Pneumonectomy and Traditional Thoracotomy Surgery for the Treatment of Tuberculous Whole Lung Destruction

XU Wenju; CHEN Sinuo; WANG Xu; WANG Wenbo; YUAN Wuying

doi:10.3969/j.issn.1004-437X.2024.20.015

Abstract：Objective To compare the clinical effects of thoracoscopic total pneumonectomy and traditional thoracotomy surgery in the treatment of tuberculous whole lung destruction.Methods A retrospective analysis was conducted on the clinical data of 68 patients with tuberculous whole lung destruction admitted to Henan Provincial Chest Hospital from November 2021 to March 2022.According to the surgical methods,the patients were divided into group A(28 cases undergoing thoracoscopic pneumonectomy)and group B(40 cases undergoing conventional thoracotomy).The clinical indexes,pain degree,lung function and postoperative complications were compared between the two groups.Results The surgical time and hospital stay in group A were shorter than those in group B,and the intraoperative bleeding was less than that in group B(P＜0.05).The visual analogue scales(VAS)scores of two groups decreased on the 1st,3rd,5th,and 7th day after surgery,but at all time points,the VAS scores of group A were lower than those in group B(P＜0.05).After surgery,total lung capacity,maximal ventilatory volume and the first expiratory volume decreased in both groups,but group A was higher than group B,with no statistical significant difference(P＜0.05).The incidence of atrial fibrillation in group A was lower than that in group B(P＜0.05).There was no statistical significant difference in the incidence of incision infection,thoracic infection,lymphatic fistula,and bronchopleural fistula between the two groups(P＞0.05).Conclusion Thoracoscopic total pneumonectomy can help shorten surgical and hospitalization time,reduce intraoperative bleeding,alleviate pain,reduce the occurrence of atrial fibrillation,and minimize lung function damage.