Video assisted thoracic surgery outcomes for primary spontaneous pneumothorax, analysis of 56 cases, single university hospital experience
Küçük Resim Yok
Tarih
2018
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Aves
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
BACKGROUND/AIMS To evaluate patients with primary spontaneous pneumothorax (PSP) who were treated via the video-assisted thoracic surgery (VATS) procedure by means of clinical features, surgical outcomes, and follow-up results. MATERIAL and METHODS We retrospectively analyzed 56 consecutive patients who underwent VATS procedure for PSP between 2012 and 2018. There were 47 male and 9 female patients with a mean age of 26.01 +/- 7.4 (18-38) years. VATS was performed under general anesthesia with double lumen intubation. Apical wedge resection and mechanical abrasion or apical pleurectomy was performed in 60% of the patients with uniportal VATS and in 40% of the patients with two portal VATS by the same surgical team. RESULTS The operation indications were recurrence in 40 (71.5%) patients, prolonged air leak in 14 (25%), and bilateral pneumothorax in 2 (3.5%). Pleurodesis procedures included upper pleural mechanical abrasion in 44 (78.5%) patients and apical pleurectomy in 12 (22.5%). Bilateral VATS procedure was performed for two patients who had bilateral pneumothorax. The mean operation time, chest tube removal time, and length of hospital stay were 26.04 +/- 4.61 (20-45) min, 1.4 +/- 0.6 (1-3) days, and 1.7 +/- 0.8 (2-4) days, respectively. No significant difference was found between uniportal and biportal VATS or mechanical abrasion and apical pleurectomy groups compared with statistical evaluation with demographic and clinical features and surgical outcomes (p>0.05). There was no mortality, and complications occurred in 16 (28.5%) patients. Only 3 (5.3%) recurrence occurred during the mean follow-up period of 48.4 +/- 11.4 (9-70) months. CONCLUSION Video-assisted thoracic surgery stapled bullectomy for PSP when followed by mechanical pleurodesis is still the gold standard and is a reliable, safe method with a low recurrence rate, complication, length of hospital stay, and quicker recovery time. The formation of new bullae-blebs could be related to continued smoking behavior that can be seen as the main reason for late period recurrences.
Açıklama
Anahtar Kelimeler
Pneumothorax, Vats, Recurrence, Videothoracoscopic Treatment, Thoracoscopic Surgery, Management, Recurrence
Kaynak
Cyprus Journal of Medical Sciences
WoS Q Değeri
N/A
Scopus Q Değeri
Cilt
3
Sayı
3
