Predictors Associated With Development Of Postoprerative Spontaneous Wound Complications After Video-assisted Thoraco-scopic Surgery

Background and Objiective: The treatment of spontaneous pneumothorax has been180years,it is common illnesses kinds thoracic surgery, the incidence has increasedin recent years. Although the majority of patients can be cured through non-surgicaltreatment, but there are still about30%of patients are often delayed healing orrecurrence[1], this study was to analyze video-assisted thoracoscopic treatment ofspontaneous postoperative pulmonary complications related factors trying to find outthe risk factors, to guide early clinical actively take preventive measures to reducesurgical complications and improve surgical results, reduce the financial burden ofpatients and other effects.Methods: Select from start VATS operation to October2012in the Second AffiliatedHospital of Shanxi Medical University Hospital line VATS VATS treatment ofspontaneous pneumothorax in patients with400cases,336cases of male, female64cases, aged16to75years, with an averageage22.54±7.98years old, weight41to86kg, an average of58.76±8.54kg, had varying degrees of preoperative chesttightness or difficulty breathing, some patients still chest pain, X-chest X-ray or chestCT diagnosis of spontaneous pneumothorax. Exclusion criteria: patients pre-existinglung infection or other infectious diseases, preoperative empirical application ofanti-infective therapy, line traumatic operation easy to secondary infection by avariety of factors transit thoracotomy in4cases not included in the statistics.400cases of postoperative complications VATS treatment of spontaneous pneumothoraxsurgery within5days after the diagnosis of pulmonary complications in40patients(10%), pneumonia in12patients (3%), atelectasis in20patients (5%), surgery leakmore than5days after the last lung8cases (2%), pulmonary hemorrhage cases andno deaths.400patients with postoperative pulmonary complications in40cases, therate was10%, essentially flat with the incidence reported in the literature.VATS patients after operation were retrospectively analyzed in400cases, included in theassessment of risk factors for a total of nine, according to different types of data usechi-square test were analyzed. The analysis of P <0.05for the difference wasstatistically signifycant.Results:400patients with postoperative pulmonary complications in40cases, therate was10%. VATS nine risk factors for perioperative chi-square test, the results areshown in Table1. Complications Male27P=0.303, age33patients over the age of50P-value less than0.05,32smoking patients P=0.04, longer operative time thereare two cases reasons the pleural cavity adhesion heavier but can be separation P=0.164, not the first time pneumothorax attack patients35P value of0.239, withcardiovascular diseases in patients P value of0.12, associated with chronic bronchitisand other lung diseases,11P value less than0.05, pleural severe adhesions chamber21P mass less than0.05, multiple bullae patients and26P value less than0.05,including age, smoking, preoperative associated with other diseases of the lungs,pleural severe adhesions, the multiple bullae five risk factors on the impact ofpostoperative pulmonary complications are more significant. Gender, operative time,pneumothorax number of episodes associated with heart disease risk factors forpostoperative pulmonary complications was not significant.Conclusion: Age, smoking, preoperative risk factors associated with postoperativecomplications associated with lung disease, severe pleural adhesions the bullaemultiple risk factors for postoperative pulmonary complications. Need extra attention,strictly control the indications for surgery, skilled master thoracoscopic techniquesand the difficulties, the surgeon carefully serious surgery, so that these can beeffective in reducing the incidence of complications.