Video Assisted Thoracic Surgery Outcomes for Primary Spontaneous Pneumothorax, Analysis of 56 Cases, Single University Hospital Experience
Cyprus Journal of Medical Sciences, cilt.3, sa.3, ss.127-131, 2018 (TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 3 Sayı: 3
- Basım Tarihi: 2018
- Doi Numarası: 10.5152/cjms.2018.409
- Dergi Adı: Cyprus Journal of Medical Sciences
- Derginin Tarandığı İndeksler: TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.127-131
- Trakya Üniversitesi Adresli: Evet
Özet
BACKGROUND/AIMSTo 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 METHODSWe retrospectively analyzed 56 consecutive patients who underwent VATS procedure for PSP between 2012 and 2018. There were 47male and 9 female patients with a mean age of 26.01±7.4 (18-38) years. VATS was performed under general anesthesia with double lumenintubation. Apical wedge resection and mechanical abrasion or apical pleurectomy was performed in 60% of the patients with uniportalVATS and in 40% of the patients with two portal VATS by the same surgical team.RESULTSThe 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%). BilateralVATS 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 differencewas found between uniportal and biportal VATS or mechanical abrasion and apical pleurectomy groups compared with statisticalevaluation with demographic and clinical features and surgical outcomes (p>0.05). There was no mortality, and complications occurredin 16 (28.5%) patients. Only 3 (5.3%) recurrence occurred during the mean follow-up period of 48.4±11.4 (9-70) months.CONCLUSIONVideo-assisted thoracic surgery stapled bullectomy for PSP when followed by mechanical pleurodesis is still the gold standard and is areliable, safe method with a low recurrence rate, complication, length of hospital stay, and quicker recovery time. The formation of newbullae-blebs could be related to continued smoking behavior that can be seen as the main reason for late period recurrences.