Clinical Analysis of Pulmonary Resection Using Staplers

자동 조직 봉합기를 사용한 폐절제술의 임상적 고찰

  • 맹대현 (인제대학교 의과대학 부속 상계백병원 흉부외과학 교실) ;
  • 곽영태 (인제대학교 의과대학 부속 상계백병원 흉부외과학 교실)
  • Published : 1996.08.01

Abstract

From 1991 to 1994, We performed 75 cases of pulmonary resection. These were divided into two groups according to the method of bronchial stump closure : 51 cases automatic staplers were a plied in 49 patients (Group 1), 24 patients were closed with manual interrupted suture (Group II). Disease entities of the patients were malignant tumor in 33 patients(Group I: Group II, 22· II, bronchiectasis in 23(18:5), benign tumor in 5(3:2), aspergilloma in 5(2:3), tuberculosis(2:1) in 3, bronchogenic cyst in 2 (0 : 2) and so on. Surgical Procedure% for these Patients were 21 Pneumonectomies(18:3), 13 bilobectomies(11:2), 26 lobectomles (14:12), 11 segmentectomies (6:5) and 4 lobectomy with segmentectomies (4:0). In conclusion, the Amount of tube drainage was smaller and the removal of chest tube after surgery was shorter than manual bronchial closure group by means of statistical significance (p=0.047, p=0.005). Although there were no statistical significance, the duration of air leakage was reduced and incidence of bronchopleural rstula was reduced in the stapler used group compared with manual bronchial closure.

1991년부터 1994년까지 75례의 폐 절제술을 시행하여 기관지 절주를 봉합하는 방법에 따라2군으로 나누었다. 49명의 환자에서 51례의 자동 조직 봉합기를 사용하였고(Group I) 24례에서 단속 수봉합 하였다.(Group II). 환자의 구성은 악성종양 3)례 (Groups:Group II, 22:11), 기관지확장증 23례 (18:5), 양성 종양 5례 (3:2), 국균증 5례 (2.3), 결핵 3례 (2:1), 기관지 선종 2례 (0:2) 등이 었다. 수술 수기는 21례의 전폐절제술(18:3), 13례의 쌍엽절제술(11:2), 26례의 폐엽절제술(14 12), 11례의 폐구역절제술(6:5)과 4례의 폐엽절제술 및 폐구역절제술(4:0)을 시행하였다. 자동 조직 봉합기를 사용한 군에서 수봉합 군보다 통계학적으로 유의하게 술후 흉관 배액량이 적었고 (p=0.047) 흉관 제거 시기가 더 빨랐다(p=0.005). 그러나 통계 학적으로 유의하지는 않았지만 술후 공기 누출 기간도 짧았고3p=0.2821 기관지 흉막루의 발생 빈도도 더 적었다.

Keywords

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