Effectiveness of Video-Assisted Thoracoscopic Surgery with Bullectomy and Partial Pleurectomy in the Treatment of Primary Spontaneous Pneumothorax—A Retrospective Long-Term Single-Center Analysis

Fung, Stephen; Ashmawy, Hany; Safi, Sami-Alexander; Schauer, Matthias; Krieg, Andreas; Schauer, Anja; Kivilis, Marius; Ziayee, Farid; Rehders, Alexander; Dizdar, Levent; Knoefel, W. T.

doi:10.3390/healthcare10030410

Cited by 3 publications

(3 citation statements)

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“…By combining bullectomy (removal of subpleural blebs or bullae) with pleurectomy, surgeons can address both the source of air leakage and minimize the risk of recurrence. This combined approach aims to provide better long‐term outcomes for patients with PSP undergoing surgical treatment 15,21 …”

Section: Discussionmentioning

confidence: 99%

“…This combined approach aims to provide better long‐term outcomes for patients with PSP undergoing surgical treatment. 15 , 21 …”

Section: Discussionmentioning

confidence: 99%

“…This combined approach aims to provide better long-term outcomes for patients with PSP undergoing surgical treatment. 15,21 Prolonged air leakage was observed in five patients (5.81%) during the study. Several risk factors may contribute to air leakage-(1) tiny blebs: three patients had numerous tiny blebs in their lung tissue, aside from the ruptured blebs/bullae; (2) lung blebs below the lung surface: these blebs may not have been completely sealed when the tissues were stapled during the procedure.…”

Section: Operative Datamentioning

confidence: 99%

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Uniportal thoracoscopic bullectomy with improved parietal pleurectomy for primary spontaneous pneumothorax

Kang,

Zheng,

et al. 2023

Clinical Respiratory J

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IntroductionParietal pleurectomy with bullectomy has been established as an effective method for preventing the recurrence of primary spontaneous pneumothorax (PSP). Our center introduced enhanced technical measures in uniportal thoracoscopic parietal pleurectomy with bullectomy for patients with PSP, aiming to document our initial experience and assess the procedure's effectiveness in preventing the recurrence of PSP.MethodsWe analyzed the clinical data of 86 patients with PSP who underwent the improved uniportal thoracoscopic parietal pleurectomy with bullectomy between July 2019 and August 2022. During the procedure, the parietal pleura above the second intercostal space was stripped but not removed. Instead, it was retained in the thoracic cavity using a piece of pedunculated pleura. Subsequently, the stumps of the lung were covered by the preserved parietal pleura.ResultsThe results of the study showed that the mean operative time was 59.87 ± 16.93 min, and the postoperative drainage duration averaged 3.94 ± 2.17 days. The mean intraoperative blood loss was 24.33 ± 48.91 ml, and the mean postoperative drainage volume was 289.00 ± 170.03 ml. Prolonged air leakage for more than 5 days was observed in five patients (5.81%), but no other postoperative complications were recorded. During the follow‐up, one patient (1.16%) experienced a recurrence of pneumothorax.ConclusionsThe perioperative results of bullectomy with the improved pleurectomy technique are deemed satisfactory. The various technical steps attempted at our center are found to be feasible and safe, and they may contribute to reducing the rates of recurrence in PSP.

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Section: Discussionmentioning

confidence: 99%

“…This combined approach aims to provide better long‐term outcomes for patients with PSP undergoing surgical treatment. 15 , 21 …”

Section: Discussionmentioning

confidence: 99%

Section: Operative Datamentioning

confidence: 99%

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Uniportal thoracoscopic bullectomy with improved parietal pleurectomy for primary spontaneous pneumothorax

Kang,

Zheng,

et al. 2023

Clinical Respiratory J

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Post-surgery spontaneous pneumothorax: Long-term recurrence rates and follow-up challenges revealed by a written survey

Nonomura,

Yabe,

Oshima

et al. 2024

PLoS ONE

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Background Spontaneous pneumothorax (SP) is a frequently encountered respiratory condition. Despite advancements in treatment techniques, there is currently no standardized treatment protocol. The aim of this study was to standardize the management of SP by collecting long-term postoperative data through written surveys. Methods Our study included 673 surgeries performed for SP at our institution between January 2011 and December 2019. We administered written surveys via mail to gather data on post-surgery recurrence rates and other related factors. The survey addressed key symptoms, medical consultations, and specific diagnoses of SP after surgery. Results The effective response rate was 70.7%, with significant differences observed across age groups. Among teenagers, the recurrence rate peaked three years postoperatively, with an ipsilateral recurrence rate of 4.8% and a contralateral incidence rate of 11.8%, both of which were significantly higher than those in other age groups. Additionally, age, sex, postoperative contralateral pneumothorax, and the period before the survey were identified as factors influencing the survey results. Conclusion This survey highlighted the need for long-term postoperative follow-up for teenagers. While written surveys have limitations, this study provided valuable data for understanding the outcomes of SP. Moving forward, it is advisable to conduct surveys using other effective tools or to continue follow-ups in outpatient clinics.

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Comparative clinical efficacy of single-incision thoracoscopic bullectomy combined with C-shaped electrocautery pleurodesis vs. chemical pleurodesis in the management of spontaneous pneumothorax

Zhong,

Wu,

Zhang

2024

Front. Surg.

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ObjectiveThis study aims to observe the clinical efficacy of single-incision thoracoscopic bullectomy combined with C-shaped electrocautery pleurodesis compared to traditional iodine chemical pleurodesis in the treatment of patients with spontaneous pneumothorax.MethodsA total of 128 patients with spontaneous pneumothorax who underwent surgical treatment at our institution from January 2021 to December 2022 were selected. Patients were categorized into the study group (n = 65) and the control group (n = 63) based on the surgical method used. The study group received C-shaped pleura cautery for pleurodesis, while the control group underwent traditional iodine chemical pleurodesis. Surgical and clinical outcomes were evaluated, and recurrence rates within one year postoperatively were compared. Serum C-reactive protein (CRP) levels and visual analog scale (VAS) scores were measured at different time points.ResultsNo significant differences were observed between the two groups regarding surgical duration, intraoperative blood loss, or postoperative hospital stay (p > 0.05). However, the study group demonstrated significantly lower serum CRP levels and VAS scores on postoperative days 1 and 2, as well as reduced drainage volumes compared to the control group (p < 0.05). The recurrence rates of pneumothorax within one year postoperatively did not differ significantly between the groups (p > 0.05).ConclusionSingle-incision thoracoscopic bullectomy combined with C-shaped electrocautery pleurodesis is an effective treatment for spontaneous pneumothorax. Compared to traditional iodine chemical pleurodesis, this method causes less pleural irritation, results in lower postoperative pain and drainage, and facilitates patient recovery, making it a safe and reliable option for the management of spontaneous pneumothorax.

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Effectiveness of Video-Assisted Thoracoscopic Surgery with Bullectomy and Partial Pleurectomy in the Treatment of Primary Spontaneous Pneumothorax—A Retrospective Long-Term Single-Center Analysis

Cited by 3 publications

References 30 publications

Uniportal thoracoscopic bullectomy with improved parietal pleurectomy for primary spontaneous pneumothorax

Uniportal thoracoscopic bullectomy with improved parietal pleurectomy for primary spontaneous pneumothorax

Post-surgery spontaneous pneumothorax: Long-term recurrence rates and follow-up challenges revealed by a written survey

Comparative clinical efficacy of single-incision thoracoscopic bullectomy combined with C-shaped electrocautery pleurodesis vs. chemical pleurodesis in the management of spontaneous pneumothorax

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