Postoperative Recurrences of Pneumothorax in Video-assisted Thoracoscopic Surgery for Primary Spontaneous Pneumothorax in Young Patients

Haraguchi, Shuji; Koizumi, Kiyoshi; Hioki, Masafumi; Orii, Koan; Kinoshita, Hiroyasu; Endo, Naoya; Tomita, Tadanori; Hoshina, Hideko; Shimizu, Kazuo

doi:10.1272/jnms.75.91

Cited by 18 publications

(11 citation statements)

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“…The postoperative recurrence rate was indicated as 0-17.9% in single-port VATS applications for spontaneous pneumothorax 6,8,9 . Eighty percent of the postoperative recurrences have occurred within the first five postoperative months 8 . The recurrence rate is stated to be higher in children and in women 1,9 .…”

Section: Discussionmentioning

confidence: 99%

“…However, it has been reported in recent studies that recurrence rates after VATS decreased with the developments in thoracoscopic instruments 6,9 . Moreover, it has been stated that postoperative recurrence may be secondary to smoking, the formation of bullae caused by antibodies against alpha 1 antitrypsinin in nonsmokers and abnormal degradation of elastic fibers of blebs 8 .…”

Section: Discussionmentioning

confidence: 99%

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Our Single-Port Video-Assisted Thoracoscopic Surgery Applications in Pneumothorax treatment

Metin¹,

Yıldırım²,

Kantekin³

et al. 2015

MMJ

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Pneumothorax is a collection of free air in the pleural cavity with resultant pulmonary collapse. Spontaneous pneumothorax is divided into two types according to the presence or absence of an underlying disease. If there is not an underlying disease, it is called "primary spontaneous pneumothorax" (PSP). If there is another underlying lung disease (e.g. COPD, tuberculosis), it is called "secondary spontaneous pneumothorax" (SSP). The various methods of simple observation, aspiration, tube thoracostomy, pleu

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Our Single-Port Video-Assisted Thoracoscopic Surgery Applications in Pneumothorax treatment

Metin¹,

Yıldırım²,

Kantekin³

et al. 2015

MMJ

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“…Yine çalışmalarda VATS ile mekanik plöredezis ve/veya plörek-tomi yapılanlarda rekürrens %0-3.6, VATS ile plörektomi uygulanmayanlarda ise bu oranın %5.9-12.5 olduğu bildirilmiştir [12][13][14][15]. Yine yapılan çalışmalarda VATS ile daha az hastanede kalış, daha az ağrı, daha az insizyon skarı olmasına rağmen, aksiller torakotomi ile karşılaştırıldığında postoperatif nüks oranı aksiller torakotomi ile büllektomi ve plörektomi yapılanlardan fazladır [16,17] Sawada ve arkadaşlarının yaptıkları VATS ile torakotomiyi karşılaştıran 281 PSP'li olgunun irdelendiği çalışmada rekürrens oranı; torakotomiden sonra %3 ve VATS'dan sonra %11.7 bulunmuştur [17]. Bunun nedeni belki akciğer ve göğüs duvarı arasında VATS ile daha az yapışıklığın oluşması olabilir.…”

Section: Discussionunclassified

Results of Mini Axillary Thoracotomy for Primary Spontaneous Pneumothorax

Yanık¹

2011

Ann Clin Anal Med

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Özet AmaçPnömotoraks sık bir klinik durum olarak bilinir. Mini aksiler torakotomi mükemmel sonuçlarla birlikte kolay apikal wedge rezeksiyon ve plörektomiye olanak vermesi nedeni ile pnömotorakslarda majör endikasyondur. Burada biz pnömotoraksta aksiller torakotomi deneyimimizi anlattık. Gereç ve Yöntemler SonuçMini aksiler torakotomi ile, hastanede kalış süresi kısa, ağrı daha az, kozmetik sonuçlar kabul edilebilirdi ve nüks yoktu. Mini aksiler torakotomi spontan primer pnömotorakslar da cerrahi gerektiği zaman hasta için mükemmel sonuçları nedeni ile iyi bir seçimdir. Anahtar KelimelerPnömotoraks, Torakotomi, Minimal İnvaziv. Abstract AimPneumothorax knows a common clinical problem. Mini axillary thoracotomy major indication is pneumothorax surgery, allowing easily apical resection and pleurectomy with excellent longterm results. Herein, we describe our experience with the axillary thoracotomy for the treatment of pneumothorax. Material and MethodsA total of 56 cases underwent mini axillary thoracotomy with the diagnosis of primary spontaneous pneumothorax in our department between 1996-2008. Fifty four of the cases were males (96.5%) and two (3.5%) were females with a mean age of 28.2 (17-43). Twenty-nine cases (51.7%) had right pneumothorax and 27 (48.3%) left pneumothorax. ResultsWe performed apical wedge resection and apical pleurectomy in 33 cases (59%), bullae ligation and apical pleurectomy in 23 cases (41%). Four patients developped morbidity. There was no mortality. Median hospital stay was 4.5 day (3-8). During 13 years follow up recurrens was not detected. ConclusionsA mini axillary thoracotomy was short hospital stay, cosmetically acceptable was not recurrence. A mini axillary thoracotomy is a good choice when a spontaneous pneumothorax requires surgery due to excellent results for the patient.

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“…Meticulous examination of the lung surfaces is vital to unveil bullae in other lobes. Seventy percent of postoperative pneumothorax recurrences probably developed because of overlooked bullae and incomplete resection of bullae in the early period of VATS experience [42]. Equally important is to scrutinise the diaphragmatic surface for fenestrations in the child-bearing age of ladies [43].…”

Section: Classification and Treatmentmentioning

confidence: 99%

Controversies in Pneumothorax Treatment

Amer¹

2019

Pneumothorax

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Surgical intervention either by video-assisted thoracoscopic surgery (VATS) or open procedure proved its worth in reducing the incidence of recurrence in pneumothorax. However, many controversies surround the management of this common medical condition. Despite advances in knowledge and technology, chest physicians and surgeons could not be more divisive about the management of pneumothorax. There are no two thoracic surgical centres and possibly no two surgeons within the same hospital that agree on the management of the different aspects of pneumothorax. The variability in reported outcomes and the paucity of published multicentre randomised controlled trials (RCT) highlight the need for further studies investigating the best options for pneumostasis and pleurodesis. This chapter aims at discussing some of these controversies and reviews the literature at its current state of evidence.2 their statement that "although thoracic surgeons are the best trained physicians to manage chest tubes and pleural problems, they often do not speak the same language or recommend similar treatment algorithms even to each other" [5]. The physiology of respiration and pneumothoraxThe pressure in the pleural space is determined by the difference between the lung elastic recoil and volume changes of the semi-rigid chest wall. The rib cage moves in three dimensions; the girdle handle movement of the ribs increases the anteroposterior and the lateral dimensions of the chest, whereas the piston-pump movement of the diaphragm leads to an increase in the vertical dimension of the chest cavity. The chest and diaphragm movements create a physiological negative pressure within the pleural space that forces the lung to change shape and volume with the respiratory cycle, resulting in inflation and deflation. Neutralising this negative pressure in the pleural space leads to lung collapse, as the elastic structure of the lung favours its collapse (recoil). Pneumothorax or air in the pleural space invariably leads to lung collapse. A thin film of fluid exists between the parietal and visceral pleurae to lubricate the sliding of these two structures, roughly 15 mls in a 70 kg adult person. The fluid is a microvascular filtrate produced by the parietal pleura and is cleared also by the parietal pleural lymphatics, a process similar to that in any other body organ.

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Postoperative Recurrences of Pneumothorax in Video-assisted Thoracoscopic Surgery for Primary Spontaneous Pneumothorax in Young Patients

Cited by 18 publications

References 15 publications

Our Single-Port Video-Assisted Thoracoscopic Surgery Applications in Pneumothorax treatment

Our Single-Port Video-Assisted Thoracoscopic Surgery Applications in Pneumothorax treatment

Results of Mini Axillary Thoracotomy for Primary Spontaneous Pneumothorax

Controversies in Pneumothorax Treatment

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