Recurrences following videothoracoscopic treatment of primary spontaneous pneumothorax: the role of redo-videothoracoscopy

Cardillo, Giuseppe; Facciolo, Francesco; Regal, Mohamed; Carbone, Luigi; Corzani, Felicita; Rícci, Alberto; Martelli, Maria Paola

doi:10.1016/s1010-7940(01)00611-x

Cited by 52 publications

(32 citation statements)

References 9 publications

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“…The safety of talc has been further established with the observation that talc poudrage does not alter lung function [117,118,125,137]. Following talc pleurodesis, VATS has been shown to be feasible [138,139]; however, it is the opinion of some Task Force members that it is more technically demanding [106]. Talc poudrage is very cost-effective and, in fact, more economical than a conservative approach using only chest tube drainage [140].…”

Section: Indicationsmentioning

confidence: 99%

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

et al. 2015

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Primary spontaneous pneumothorax (PSP) affects young healthy people with a significant recurrence rate. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research.The European Respiratory Society's Scientific Committee established a multidisciplinary team of pulmonologists and surgeons to produce a comprehensive review of available scientific evidence.Smoking remains the main risk factor of PSP. Routine smoking cessation is advised. More prospective data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP, treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is available. Video-assisted thoracic surgery is preferred to thoracotomy as a surgical approach.In first episodes of PSP, aspiration is required only in symptomatic patients. After a persistent or recurrent PSP, definitive treatment including pleurodesis is undertaken. Future randomised controlled trials comparing different strategies are required. @ERSpublications A European Task Force reviews scientific evidence and suggests future research for primary spontaneous pneumothorax

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Section: Indicationsmentioning

confidence: 99%

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

et al. 2015

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“…The bullae/blebs in patients with PSP can be managed through VATS by stapling and resection, no-knife stapling, suturing, or endo-loop ligation (Liu et al, 1999;Cardillo et al, 2001;Luh and Liu, 2006). Pleurodesis is usually required in addition to bullae/ blebectomy for surgical management of patients with PSP.…”

Section: Surgical Management Of Pspmentioning

confidence: 99%

Diagnosis and treatment of primary spontaneous pneumothorax

Luh

2010

J. Zhejiang Univ. Sci. B

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Primary spontaneous pneumothorax (PSP) commonly occurs in tall, thin, adolescent men. Though the pathogenesis of PSP has been gradually uncovered, there is still a lack of consensus in the diagnostic approach and treatment strategies for this disorder. Herein, the literature is reviewed concerning mechanisms and personal clinical experience with PSP. The chest computed tomography (CT) has been more commonly used than before to help understand the pathogenesis of PSP and plan further management strategies. The development of video-assisted thoracoscopic surgery (VATS) has changed the profiles of management strategies of PSP due to its minimal invasiveness and high effectiveness for patients with these diseases.

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“…Some authors have suggested that a complete pleurolysis should be performed to search for bullae missed at first operation [6]. In the largest series of redo VATS after such recurrences, Cardillo et al operated on 19 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Complete adhesiolysis was performed in all cases. But bullae were found and stapled in only nine cases [6]. However, this method entails the risk of injuring the lung during adhesiolysis.…”

Section: Discussionmentioning

confidence: 99%

Results of thoracoscopic pleural abrasion for primary spontaneous pneumothorax

et al. 2004

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A 73-year-old woman with a 1-month history of dyspnea on exertion and a history of hypertension and hyperlipide-mia was referred for the evaluation of a left pleural effusion of unknown etiology. She had no history of malignancy. Diagnostic thoracoscopy under local anesthesia using a semi-rigid scope (LTF-240; Olympus, Tokyo, Japan) revealed numerous black tumors of varying size throughout the parietal and visceral pleura and the diaphragm surface (PictureA) and a large black-pigmented pleural tumor (PictureB). After a biopsy, a histopathological analysis of the mass and nod-ules revealed malignant cells with melanin-filled cytoplasm, indicating malignant melanoma. She was then referred to a dermatologist for systemic chemotherapy. Despite a thorough evaluation, no primary lesions were detected. Therefore , the most likely diagnosis was primary pleural mela-noma. Intrathoracic metastasis from melanoma is common, whereas primary pleural melanoma is extremely rare. Our patient had a pleural tumor diagnosed via thoracoscopy under local anesthesia showing massive black tumors spreading throughout the pleura. The authors state that they have no Conflict of Interest (COI).

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Recurrences following videothoracoscopic treatment of primary spontaneous pneumothorax: the role of redo-videothoracoscopy

Abstract: In the light of our initial experience, redo-VATS seems to be a promising tool for the surgical therapy of recurrences following VATS treatment of primary spontaneous pneumothorax.

Cited by 52 publications

References 9 publications

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

Diagnosis and treatment of primary spontaneous pneumothorax

Results of thoracoscopic pleural abrasion for primary spontaneous pneumothorax

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