Optimal surgical technique in spontaneous pneumothorax: a systematic review and meta-analysis

Sudduth, Christopher L.; Shinnick, Julia; Geng, Zhi; McCracken, Courtney; Clifton, Matthew S.; Raval, Mehul V.

doi:10.1016/j.jss.2016.10.024

Cited by 52 publications

(37 citation statements)

References 43 publications

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“…6 A review indicates that wedge resection is favored for the management of PSP, while an additional pleural abrasion or chemical pleurodesis could be considered to potentially decrease the risk of recurrence after surgery. 7 However, surgery should also be selected strictly based on the risk factors and the patients' wishes to avoid overtreatment. 8 U-VATS may have advantages over a multiport procedure in terms of postoperative pain, 9,10 but high-quality evidence is still lacking.…”

Section: Discussionmentioning

confidence: 99%

Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture

Zhang

et al. 2020

J Int Med Res

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Manipulating the instruments during uniportal video-assisted thoracoscopic surgery (U-VATS) bullectomy requires a relatively large incision. This study aimed to investigate the feasibility of next-day discharge following U-VATS bullectomy using an anchoring suture. Methods: A stapler and a scope were inserted through a single incision in the anchoring group. The bullae were retracted by the suture, which was inserted from outside of the chest wall into the thorax, and then bullectomy was performed. For those in the control group, resection of the bullae was performed with the assistance of a grasping forceps. Results: The length of the incision of the patients in the anchoring group ([13.2 AE 2.2] mm) was significantly smaller than in the control group ([26.2 AE 3.9] mm). In addition, the number of staplers used in the anchoring group was significantly less than in the control group ([1.2 AE 0.4] vs. [1.4 AE 0.5]). Furthermore, 36 (92.3%) cases in the anchoring group were uneventfully discharged within 24 hours after bullectomy. Conclusion: Next-day discharge after U-VATS bullectomy through a small incision assisted with an anchoring suture is safe and feasible.

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Section: Discussionmentioning

confidence: 99%

Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture

Zhang

et al. 2020

J Int Med Res

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“…A meta-analysis comparing the different combinations of intraoperative treatment for primary spontaneous pneumothorax found that wedge resection combined with chemical pleurodesis, as well as wedge resection, combined with both mechanical pleural abrasion and chemical pleurodesis, had the lowest recurrence rates. Although Video-Assisted Thoracoscopy in the Management of Primary and Secondary Pneumothorax DOI: http://dx.doi.org /10.5772/intechopen.83669 the complications of these procedures were not taken into account favoring chemical or mechanical pleurodesis, in addition to wedge resection to remove the source of the air leak [21,22]. Mechanical pleurodesis should be considered on a case-by-case basis with good clinical judgment.…”

Section: Managementmentioning

confidence: 99%

“…When comparing VATS to other treatment modalities, such as aspiration, chest tube drainage, and pleurodesis, a recent meta-analysis of all available randomized control trials showed that VATS had the most favorable results with regard to recurrence and hospitalization days [21,22]. The addition of pleurodesis to VATS bullectomy compared to VATS bullectomy alone further decreases recurrence rates, although this strategy comes with associated complications that include pain [21,22]. Given the increased complications that arise from pleurodesis, some novel attempts at replacing the procedure, and at the same time achieving the same goal of promoting adhesions, have been developed.…”

Section: Managementmentioning

confidence: 99%

Video-Assisted Thoracoscopy in the Management of Primary and Secondary Pneumothorax

Poulikidis¹,

Gerson²,

Costello³

et al. 2019

Pneumothorax

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The management of primary and secondary spontaneous pneumothorax can have many variations depending on the surgeons and their expertise of practice. The end goal is to stop the recurrence. The history of treatment, clinical indications for surgery, and preoperative and postoperative decision-making for intervention are summarized. Surgical intervention plays an important role in the management of recurrent pneumothorax and complex initial pneumothorax. Over the years the surgical techniques have evolved, and currently, video-assisted thoracoscopic techniques are frequently used in the management. In this concise report, we attempt to analyze the surgical techniques currently in use and their outcomes. Furthermore, we attempt to integrate future innovations in the management of this common disorder.

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“…Зокрема, рекомендації British Thoracic Society, засновані на результатах робіт 1-го і 2-го рівнів доказовості, свідчать про те, що тільки таке радикальне за своїм обсягом втручання, як резекція легені з плевректомією, забезпечує найменший відсоток рецидивів пневмотораксу (близько 1,0% ) [3,5].…”

Section: вступunclassified

Videotracoscopic Interference With Bullous Emphysema Complicated by Spontaneous Pneumothorax

Boyko¹,

Gaft²,

Nakonechny³

et al. 2019

Khark. Surg. Sch.

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Objective. To study the factors of a large number of relapses of spontaneous pneumothorax in bullous emphysema (BE) of the lungs and to improve the results of treatment of patients with various forms of BE with the help of developed methods. Methods. The study is based on the study of the results of surgical treatment of 423 patients with different forms of BE, which used traditional and developed surgical tactics using patented methods for determining the elastic capacity of pulmonary tissue and autohemoplévoidosis as an integral component of radical surgical interventions. Results. The use of developed surgical tactics using videotrakaskopicheskoy biopsy to further determine the destructive index in patients with different forms of BE has reduced the overall number of relapses from 18.8% in the comparison group to 5.1%. Conclusion. Videotracoscopic biopsy with the definition of a destructive index allows to more objectively distribute FE in forms that allows to choose optimal surgical tactics.

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Optimal surgical technique in spontaneous pneumothorax: a systematic review and meta-analysis

Cited by 52 publications

References 43 publications

Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture

Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture

Video-Assisted Thoracoscopy in the Management of Primary and Secondary Pneumothorax

Videotracoscopic Interference With Bullous Emphysema Complicated by Spontaneous Pneumothorax

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