Approach to pneumothorax surgery: a national survey of current UK practice
| Autor: | Michael Shackcloth, Joseph Zacharias, Muhammad Asghar Nawaz, Denish Apparau |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Time Factors Computer-assisted web interviewing Time-to-Treatment Postoperative Complications Recurrence Medicine Humans Healthcare Disparities Practice Patterns Physicians' Pleurodesis Surgeons business.industry Thoracic Surgery Video-Assisted Pneumothorax General Medicine medicine.disease United Kingdom Treatment Outcome Health Care Surveys Drainage Surgery Medical emergency Current (fluid) Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed Ireland |
| Zdroj: | Asian cardiovascularthoracic annals. 27(3) |
| ISSN: | 1816-5370 |
| Popis: | Background Pneumothorax is a common condition with various management options. We aimed to determine the current surgical practice in the United Kingdom. Method An online questionnaire regarding surgical strategy was sent to all consultants who were members of the Society for Cardiothoracic Surgery (80 thoracic). Results Fifty-six consultants, mainly thoracic, responded to the survey. Video-assisted thoracoscopic surgery was unanimously the preferred approach, the majority (59%) using 3 ports. Regarding the timing of surgery, 53 (95%) surgeons would intervene at first presentation with persistent air leak and/or lung collapse, 41 (73%) for a first bilateral pneumothorax, 22 (39%) only for recurrent pneumothorax, and 18 (32%) for the first computed tomography evidence of bullae. Apical bullectomy + pleurectomy was the preferred technique for 26 (46%) surgeons, and apical bullectomy + apical pleurectomy + pleural abrasion was the choice for 13 (23%). Some surgeons were concerned about talc and avoid it. The majority (70%) used a single apical drain with or without 24–48 h suction. Regarding chest radiography, the response was variable but 48% performed immediate postoperative and/or daily chest radiographs. Currently, most surgeons (59%) use digital drains and feel it monitors air leaks better. The perceived chronic pain (1%–3%) and recurrence rates (0%–3%) were stated by 59% and 86%, respectively. Conclusion There is variability in the surgical management of pneumothorax among surgeons across the UK, but they all use video-assisted thoracoscopic surgery as the intervention of choice for pneumothorax surgery, and there is a shift towards early surgical intervention. |
| Databáze: | OpenAIRE |
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