Therapie des Spontanpneumothorax — Chirurgische Therapie

Krumhaar, D; Mollinedo, J.; Gau, A.

doi:10.1007/978-3-642-48161-1_95

Cited by 2 publications

(4 citation statements)

References 2 publications

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“…It remains possible that all PSP patients do in fact have bullae and bleb formation, a belief which is held by some authors [1,2,18].…”

Section: Discussionmentioning

confidence: 95%

“…The negative pre dictive results of the study apologize the lack of controls, additionally. The lack of a control group in CT examina tion and of surgical controls of the CT results in patients limits the value of our findings; the unusual surgical treat ment of the first episode of pneumothorax [1] for getting control material could not be included in the study proto col.…”

Section: Limitations O F the Studymentioning

confidence: 88%

“…This is in accord ance with the combined results of other, mainly retrospec tive, studies, i.e., 25% (n = 921 PSP patients) [2, 3, 6-9, 11, 32, 35, 37], The choice of therapy in PSP has a decisive ef fect on the recurrence rate of PSP. After simple aspira tion, the recurrence was 48% (n = 291) [2,3,6,11], whereas with surgery (in both PSP and recurrent PSP), the recur rence is reduced to 0.6%, impressively (n = 1,038) [1][2][3][4][5][6][7][8][9][10]20,[31][32][33][34][35]37], For this reason, we paid close attention to the standardization of our therapeutic procedures. Because of its high relapse rate, aspiration therapy may not be recom mended in the treatment of PSP.…”

Section: Discussionmentioning

confidence: 99%

“…Thoracoscopic studies carried out on PSP patients [4,9,[10][11][12], revealed pathologic findings in about 66% (n = 742 PSP patients). Furthermore, large bullae had not been recognized by thoracoscopy [20], Macroscopic operative findings in surgery revealed bullae and bleb formation or fibrotic changes in about 92% (n = 595) [1][2][3][4][5][6][7][8] of pneumothorax cases irrespective of the type of pneumothorax -primarily operated PSP [1] or recurrent pneumothorax [2][3][4][5][6][7][8], In the present study, CT achieved comparable results in the diagnosis of bullae and bleb formation (88 vs. 92%).…”

Section: Discussionmentioning

confidence: 99%

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Value of Computer Tomography in the Detection of Bullae and Blebs in Patients with Primary Spontaneous Pneumothorax

Mitlehner¹,

Friedrich

Dissmann³

1992

Respiration

137

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In this prospective study, the value of computed tomography (CT) in detecting bullae and bleb formation of the lung in 35 patients with primary spontaneous pneumothorax (PSP) has been determined. The ability of CT in the detection of bullae and bleb formation and fibrotic changes is compared with the chest film in PSP. CT showed pathological lung changes in 31/35 patients. In most cases, few (n < 5) and small blebs (i.e., < 2 cm in diameter) were found. In 16/35 cases, blebs ( < 2 cm) and bullae ( > 2 cm in diameter) occurred in the extra-apical region. Contralateral pathological changes were found in 23/35. Bullae ( > 2 cm) could be detected only in 6/35. In the chest film, bullae and blebs could be detected in 11/35 cases on the ipsilateral (in 2/35 cases not confirmed by CT), in 3/35 on the bilateral and in 4/35 only on the contralateral side. Thus, CT was proved to be of high value in the assessment of bullae and bleb formation in PSP compard with chest film. Negative pressure drainage was instituted as primary therapy. In a follow-up of 9.6 ( ± 5.7 SD) months, only early recurrences were noticed (n = 35). The rate of recurrences was 6/35 patients. The longer follow-up period (mean 31.7 ± 6.1 months) could be performed for 32 patients; 3 were lost. Additionally, 2 recurrences occurred. No correlation between recurrences and anatomical status (number, size and distribution of blebs/bullae) as assessed by CT was found. Differential treatment protocols on the basis of the initial findings do not appear to be warranted.

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“…It remains possible that all PSP patients do in fact have bullae and bleb formation, a belief which is held by some authors [1,2,18].…”

Section: Discussionmentioning

confidence: 95%

Section: Limitations O F the Studymentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Value of Computer Tomography in the Detection of Bullae and Blebs in Patients with Primary Spontaneous Pneumothorax

Mitlehner¹,

Friedrich

Dissmann³

1992

Respiration

137

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Die Behandlung des Spontanpneumothorax

Gebhardt

Bölcskei

Wilkening

et al. 1989

Langenbecks Arch Chiv

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Experience with 300 episodes of spontaneous pneumothorax in 209 patients is reported. The treatment results of two time periods 1980-1983 (A) and 1985-1987 (B) are compared. During the second period the diagnostic work-up was much more extensive and included pleurography, CT-scan and thoracoscopy. This resulted in a more differentiated therapy and a reduction in the recurrence rate from 41% to 22%. Among the different modes of treatment chest-tube drainage alone had the worst results with a 44% rate of early and late recurrence. Better results were obtained with pleurodesis using fibrin adhesive either through a pleural catheter (24%) or thoracoscopically (13%). Operative treatment had the lowest recurrence rate (4%). In the primary treatment of spontaneous pneumothorax chest-tube drainage had a recurrence rate of 33% and catheter-pleurodesis with fibrin adhesive of 18% while no relapse could be observed in the group treated by thoracoscopy or operation. In the treatment of recurrent pneumothorax chest-tube drainage alone is unsuitable because of a failure rate of 64%. Catheter pleurodesis also had a high rate of recurrence (30%). The best results were again obtained by thoracoscopic (19%) and operative treatment (4%). On the basis of the described experience an individualized approach to the treatment of spontaneous pneumothorax is recommended.

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Therapie des Spontanpneumothorax — Chirurgische Therapie

Cited by 2 publications

References 2 publications

Value of Computer Tomography in the Detection of Bullae and Blebs in Patients with Primary Spontaneous Pneumothorax

Value of Computer Tomography in the Detection of Bullae and Blebs in Patients with Primary Spontaneous Pneumothorax

Die Behandlung des Spontanpneumothorax

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