Should surgical pleurectomy for spontaneous pneumothorax be always thoracoscopic?

Interactive Cardiovascular and Thoracic Surgery
Rizwan A QureshiRobert Norton

Abstract

Fifty-seven patients were studied over a period of three years to analyse the efficacy of surgical pleurectomy for spontaneous pneumothorax. Thirty-one and 26 patients underwent open and video-assisted thoracoscopic surgery (VATS) pleurectomy, respectively. VATS was the main modality used for primary spontaneous pneumothorax (PSP) (21 vs. 8). However, secondary spontaneous pneumothorax (SSP) was mainly managed with open pleurectomy (23 vs. 5). The median operating time was significantly longer in open group (72.4 vs. 55 min; P=0.005). The amount of analgesia required in the first five days was significantly more in open group (108 mg vs. 46.9 mg; P=0.02). Chest drainage was significantly more in open group (1027.1 ml vs. 652.8 ml; P=0.04). However, chest drain duration and hospital stay had no significant difference. VATS emerged as a cost-effective modality (1770 pounds vs. 3226 pounds). The ability to return to work was significantly earlier in VATS group in PSP patients (6 weeks vs. 10 weeks; P=0.007). There were 3 (5.27%) recurrences in VATS group for patients with SSP. This experience suggests that VATS pleurectomy is an appropriate modality for PSP. However, open pleurectomy is a viable alternative to treat SSP.

Citations

Dec 1, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Kasra ShaikhrezaiWilliam S Walker
Dec 1, 2009·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Mirko ZganjerVlasta Zganjer
May 16, 2013·Interactive Cardiovascular and Thoracic Surgery·Mitsuhiro IsakaNorikazu Urabe
Mar 11, 2016·General Thoracic and Cardiovascular Surgery·Hitoshi IgaiKimihiro Shimizu
Jun 24, 2010·Magyar sebészet·Zsolt SzentkeresztySándor Sz Kiss
Apr 29, 2014·Asian Cardiovascular & Thoracic Annals·Hideki OtaTsubasa Matsuo
Jun 27, 2015·The European Respiratory Journal·Jean-Marie TschoppGiuseppe Cardillo
Jan 16, 2015·Journal of Bronchology & Interventional Pulmonology·Olanisun Olufemi AdewoleMarc Noppen
Oct 12, 2019·Interactive Cardiovascular and Thoracic Surgery·Shunichi NagataHideki Motoyama

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