Comparison of patient-reported outcomes and clinical outcomes between pleurectomy and pleural covering added to thoracoscopic bullectomy for primary spontaneous pneumothorax

Abstract

Background An optimal surgical procedure for primary spontaneous pneumothorax (PSP) has not yet been established. The study aimed to compare patient-reported outcomes (PROs) and clinical outcomes between parietal pleurectomy (pleurectomy) and visceral pleural covering with absorbable prosthesis (covering) added to thoracoscopic bullectomy in patients with PSP. Methods From January 2015 to April 2018, PROs were prospectively evaluated using EuroQOL-5 dimensions-5 levels (EQ5D). Questionnaires were administered preoperatively and at 1, 3, and 5 days and 1 month postoperatively. The perioperative outcomes were compared retrospectively. Recurrences and postoperative symptoms in the distant period were investigated cross-sectionally by telephone and mail surveys in February 2020. Results In total, 26 and 29 patients underwent covering and pleurectomy, respectively. The visual analog scale score of the EQ5D on postoperative day 1 was significantly better in the pleurectomy group than in the covering group. There was no significant difference in the frequency of PROs in the EQ5D including pain. Perioperative outcomes, such as postoperative chest tube placement, and hospital stay, were comparable between the groups, except for the operative time. There was no significant difference in the recurrence rate and frequency of residual symptoms, e.g., chest discomfort in the long-term outcomes. Conclusions PROs and clinical outcomes were comparable between the two procedures. Further studies are required to determine the optimal treatment procedure.

Monitoring of spontaneous pneumothorax using electrical impedance tomography: A case report

“…Pneumothorax is categorized as spontaneous pneumothorax and non-spontaneous such as traumatic with iatrogenic or no iatrogenic etiology [ 8 ]. Spontaneous pneumothorax is further divided into primary and secondary subtypes [ 9 , 10 ]. Primary spontaneous pneumothorax (PSP) occurs in patients with no obvious lung disease, while secondary spontaneous pneumothorax frequently occurs in elderly people with underlying lung conditions [ 11 , 12 ].…”