Postoperative recurrences of pneumothorax in video-assisted thoracoscopic surgery for primary spontaneous pneumothorax in young patients.
نویسندگان
چکیده
PURPOSE The postoperative recurrence rate of pneumothorax tends to be higher with thoracoscopic bullectomy than with conventional plication of bullae by axillary thoracotomy or posterolateral thoracotomy. We analyzed the risk factors for postoperative recurrence of pneumothorax in young patients treated with thoracoscopic bullectomy alone for primary spontaneous pneumothorax. METHODS Univariate and multivariate analyses were performed of a consecutive series of 53 patients (62 sides) who underwent video-assisted thoracoscopic bullectomy from March 1994 through March 2004. RESULTS Pneumothorax recurred after 10 operations (16.1%). Eighty percent of postoperative pneumothorax recurrences developed within 5 months after surgery. Univariate analysis of postoperative pneumothorax recurrences revealed significant risk factors to be the early period of video-assisted thoracoscopic surgery (VATS) experience for primary spontaneous pneumothorax and a low number of pack-years (p<0.05 and p<0.05, respectively). Multivariate logistic regression test revealed that the early period of VATS experience was the single significant risk factor (odds ratio, 0.275; 95% confidence interval, 0.095-0.797; p value, 0.0174). Seventy percent of postoperative pneumothorax recurrences probably developed because of overlooked bullae and incomplete resection of bullae in the early period of VATS experience. Close observation of the pleural cavity to find bullae and bullectomy with a sufficient margin of normal pleurae and pulmonary parenchyma prevented postoperative pneumothorax recurrences significantly in the middle and recent periods. CONCLUSION Close observation of the pleural cavity to find bullae and bullectomy with a sufficient margin of normal pleurae and pulmonary parenchyma are important measures for preventing postoperative recurrence of pneumothorax.
منابع مشابه
Video-assisted Thoracoscopic Surgery Versus Axillary Thoracotomy in Primary Spontaneous Pneumothorax
Introduction: Video-assisted thoracic surgery (VATS) is now commonly used for primary spontaneous pneumothorax. In the present study we compared the outcomes of this technique with those obtained by conventional thoracotomy.Material and Methods: In this cross-sectional stud, forty patients were enrolled into two groups: VATS (n=20) and thoracotomy (n=20). In both groups the blebs were resected ...
متن کاملThe results of thoracoscopic surgery for primary spontaneous pneumothorax.
OBJECTIVE To review our experience of video-assisted thoracoscopic surgery for the treatment of primary spontaneous pneumothorax. DESIGN Longitudinal cohort study following up consecutive patients for 3 to 4.3 years. SETTING Thoracic Surgery Department, Chest Diseases Hospital, Kuwait. PATIENTS AND INTERVENTION Seventy-two consecutive patients undergoing thoracoscopy for primary spontaneo...
متن کاملVideo-assisted thoracoscopic surgery for pneumothorax.
Five cases of spontaneous pneumothorax were treated with video-assisted thoracoscopic surgery (VATS). These included four cases of recurrent pneumothorax and one case of persistent pneumothorax. The mean age was 33 years. The identified bullae were eliminated with either endoloop ligation (in one patient) or stapled excision (in four patients). There were no recurrences reported in a mean follo...
متن کامل[Video-assisted thoracoscopic surgery in the treatment of pneumothorax: 107 consecutive procedures].
The aim of this prospective study was to evaluate video-assisted thoracoscopic surgery (VATS) in primary and secondary spontaneous pneumothoraces. Over a 37-month period, 107 videothoracoscopic interventions were performed to treat spontaneous pneumothorax in 105 patients, 78 men and 27 women, whose average age was 28 years.Indications for surgery included recurrent ipsilateral pneumothorax (47...
متن کاملVideo-Assisted Thoracoscopic Suture Closure of Blebs to Treat Primary Spontaneous Pneumothorax
BACKGROUND AND OBJECTIVES If surgery is indicated for primary spontaneous pneumothorax (PSP), video-assisted thoracoscopic surgery (VATS) using an endoscopic linear cutter to resect the involved blebs is the most popular treatment. We tried to determine whether closure of the blebs with sutures without resection is also efficacious enough to treat PSP. METHODS We prospectively analyzed 22 epi...
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ورودعنوان ژورنال:
- Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
دوره 75 2 شماره
صفحات -
تاریخ انتشار 2008