慢性膿胸に対する近中法(肋骨骨膜外空気充填術)の成績と適応拡大

概要

論文の詳細を見る
During the period from June 1983 to June 1992, extraperiosteal air-plombage (Kinchu-Method) was performed in 58 cases of chronic empyema (tuberculous chronic empyema: 51, non-tuberculous chronic empyema: 7) in the Department of Thoracic Surgery, Tokyo Metropolitan Fuchu Hosoital. Though the success rate of primary surgery was 76% and the cure rate was 95%, the outcome was very good, with only one case of operation-related death (1.7%). Against 12 out of 14 cases in which the primary surgery failed, a modified Grow-Kergin Method was additionally performed, which resulted in a cure in 11 cases. Other successfully treated cases included chronic hemorrhagic empyema, empyema after plastic ball plombage, aspergillus cavity perforative empyema, empyema necessitatis after pneumonectomy, and empyema with a bronchopleural fistula after pneumonectomy. In 30 additional cases with poor lung function having the index of 40% or less, good results were obtained. Though a pleuropneumonectomy represents a large-scale operative invasion with a high rate of operation-related death, this method was shown to be a considerably safe maneuver with a very low incidence (1.7%) of operative mortality, and thus it seemed applicable in patients with severely disturbed lung function.
東京女子医科大学の論文
2000-12-25