Video-assisted thoracic surgery: primary therapy for spontaneous pneumothorax?
| Autor: | Alim Khandekar, Francis H. Cole, J. Matthew Maxwell, F. Hammond Cole, James W. Pate, William A. Walker |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty medicine.medical_treatment Video Recording Thoracostomy Primary therapy Recurrence medicine Thoracoscopy Humans Thoracotomy Retrospective Studies medicine.diagnostic_test business.industry Pneumothorax Length of Stay Middle Aged medicine.disease Endoscopy Surgery Chest tube Treatment Outcome Cardiothoracic surgery Anesthesia Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of thoracic surgery. 60(4) |
| ISSN: | 0003-4975 |
| Popis: | Background. This study assessed the role of video-assisted thoracic surgery (VATS) in current therapy for spontaneous pneumothorax. Methods. We compared a retrospective series of 89 patients treated conventionally with a consecutive group of 30 patients undergoing VATS pleural abrasion. The 89 earlier patients were predominantly male (81%). Treatment groups included observation/aspiration (7 or 17%), tube thoracostomy (32 or 36%), multiple tubes (7 or 9%), and thoracotomy (43 or 48%). Of the 30 patients treated with VATS, 18 (66%) were male. Primary indications for operation were recurrent pneumothorax (17) and persistent air leak (9). Results. Hospital lengths of stay (LOS) for the earlier group were 5 days for simple tube and 7 days for primary thoracotomy; LOS for initial intervention followed by thoracotomy exceeded 15 days in all subgroups. The average LOS in the VATS group was 13 days; 6 patients treated with primary VATS (no chest tube) had a mean LOS of 6.5 days. Complications included 3 (10%) prolonged air leaks (more than 7 days) and 2 (7%) early recurrences. Conclusions. We do not recommend VATS as primary therapy for spontaneous pneumothorax; tube thoracostomy remains the treatment of choice. However, we strongly support surgical intervention early (3 days) in patients with a persistent air leak, and as primary therapy in a nonurgent situation if standard indications exist. This study shows no advantage of VATS over conventional thoracotomy in hospital stay or complication rate. |
| Databáze: | OpenAIRE |
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