초록접수 현황
| 20F-143 | 구연 발표 |
The feasibility of sternal sparing procedure comparing to clamshell incision in bilateral lung transplantation
Joohyung Son, Sung Kwang Lee, Bong Soo Son, Do Hyung Kim
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Gyoungnam, South Korea
Purpose : Clamshell is the standard approach used for lung transplantation. However, sternal instability and excessively large incision may cause wound complications and respiratory difficulty. Some institutions have implemented sternal sparing bilateral anterior thoracotomies to solve this problem. The purpose of this study is to evaluate the usefulness of sternal sparing thoracotomy.
Methods : A retrospective analysis of 78 consecutive bilateral lung transplants performed from May 2013 to February 2020. Bilateral anterior thoracotomies was introduced since January 2018. 34 patients underwent clamshells and 44 patients underwent bilateral anterior thoracotomies. We retrospectively compared the clinical results between two groups.
Results : There were no significant differences in operation time (11.9±1.8 vs 11.2±2.2, p=0.980) between clamshells and sternal sparing group. At POD 0, the amount of blood transfusion is 2684.7±3901.3 cc in Clamshell and 1618.1±1513.8 cc in sternal sparing group (p=0.101). Median time until extubation was 29.06±20.80 days in Clamshell and 19.5±21.8 days in sternal sparing group (p=0.561) and ICU stay also showed no statistically significant difference (32.3±22.5 vs28.41±30.66 days, p=0.528). The incidence of sternal wound dehiscence 6 patients in Clamshell and 0 in sternal sparing incision (17.6% vs 0%, p<0.05). In hospital mortality developed in 3 patients, 50% of patients with sternal wound dehiscence. In hospital mortality was no difference in two groups (23.5% vs 18.2%, P = 0.432).
Conclusion : Less invasive lung transplantation of the lung via sternum-sparing anterolateral thoracotomies is a safe procedure with low associated morbidity and favorable outcomes.
Methods : A retrospective analysis of 78 consecutive bilateral lung transplants performed from May 2013 to February 2020. Bilateral anterior thoracotomies was introduced since January 2018. 34 patients underwent clamshells and 44 patients underwent bilateral anterior thoracotomies. We retrospectively compared the clinical results between two groups.
Results : There were no significant differences in operation time (11.9±1.8 vs 11.2±2.2, p=0.980) between clamshells and sternal sparing group. At POD 0, the amount of blood transfusion is 2684.7±3901.3 cc in Clamshell and 1618.1±1513.8 cc in sternal sparing group (p=0.101). Median time until extubation was 29.06±20.80 days in Clamshell and 19.5±21.8 days in sternal sparing group (p=0.561) and ICU stay also showed no statistically significant difference (32.3±22.5 vs28.41±30.66 days, p=0.528). The incidence of sternal wound dehiscence 6 patients in Clamshell and 0 in sternal sparing incision (17.6% vs 0%, p<0.05). In hospital mortality developed in 3 patients, 50% of patients with sternal wound dehiscence. In hospital mortality was no difference in two groups (23.5% vs 18.2%, P = 0.432).
Conclusion : Less invasive lung transplantation of the lung via sternum-sparing anterolateral thoracotomies is a safe procedure with low associated morbidity and favorable outcomes.
책임저자: Do Hyung Kim
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Gyoungnam, South Korea
발표자: Joohyung Son, E-mail : pnumed09@naver.com