Percutaneous endoscopic debridement and irrigation for thoracic infections

摘要

OBJECTIVE: To investigate the safety and efficacy of percutaneous endoscopic debridement and irrigation for thoracic infections and tomake an appropriate choice according to the patient’s condition.METHODS. Thirty patients with thoracic infections who received surgical treatment from August 2014 to December 2016 were retrospectivelyanalyzed. There were 16 males and 14 females, aged from 41 to 90 years, with an average of 64.4 years. A total of 9 cases weretreated with percutaneous endoscopic debridement and irrigation (minimal group), and 21 cases were treated with open debridementin combination with pedicle screw fixation (conventional group). Patients underwent follow-up for 1 month. General condition, operativeindex, laboratory results, and imaging features were recorded.RESULTS. Compared with the conventional group, there were more comorbidities in patients in the minimal group (8 cases in the minimalgroup, 10 cases in the conventional group, P=0.049), shorter hospital stay (10.1 + 2.26 days in the minimal group, 16.1 + 6.81 daysin the conventional group, P=0.016), less bleeding volume (383.3 + 229.86ml in the minimal group, 90 + 11.18ml in the conventionalgroup, P=0.000), lower VAS score at discharge (2.9 + 0.93 in the minimal group, 3.9 + 0.91 in the conventional group, P=0.013). Therewas no spinal instability case in the minimal group, 10 cases in the conventional group, P=0.013. There were significant differences. TheC reaction protein prior to operation in the minimal group was 28.4±7.50mg/L. Compared with 45.1 + 15.78mg/L in the conventionalgroup, P=0.005, it was lower.CONCLUSIONS. Percutaneous endoscopic debridement and irrigation are an effective surgery for treatment of thoracic infections, especiallysuitable for patients with comorbidities and poor general condition. However, for severe infection and spinal instability, we tendto choose open surgery in combination with fixation.