Implementation of a Clinical Pathway in Primary Spontaneous Pneumothorax Patients Treated by Wedge Resection Surgery

2010 ◽  
Vol 24 (6) ◽  
pp. 295-303 ◽  
Author(s):  
JINA MO ◽  
HYUNSOO OH ◽  
YOUNGMEE AHN ◽  
WHASOOK SEO
Keyword(s):  
Clinical Pathway ◽  
Spontaneous Pneumothorax ◽  
Wedge Resection ◽  
Primary Spontaneous Pneumothorax

scholarly journals Efficacy and safety of pleurectomy and wedge resection versus simple pleurectomy in patients with primary spontaneous pneumothorax

2019 ◽  
Vol 11 (12) ◽  
pp. 5502-5508
Author(s):  
Agata Dżeljilji ◽  
Krzysztof Karuś ◽  
Artur Kierach ◽  
Barbara Kazanecka ◽  
Wojciech Rokicki ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Wedge Resection ◽  
Primary Spontaneous Pneumothorax ◽  
Efficacy And Safety

scholarly journals Pleurodesis methods in the surgical treatment of primary spontaneous pneumothorax

2021 ◽  
pp. 77-81
Keyword(s):  
Surgical Treatment ◽  
Recurrence Rate ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Primary Spontaneous Pneumothorax ◽  
High Recurrence Rate ◽  
Parietal Pleura ◽  
Advantages And Disadvantages ◽  
Video Assisted Thoracoscopic Surgery

Pneumothorax is the collection of air in the pleural space. Pneumothorax can be spontaneous, traumatic or iatrogenic. Primary spontaneous pneumothorax mostly occurs in healthy individuals without an apparent cause, probably due to the rupture of subpleural emphysematous bullae located on the apex of the lung. It usually occurs in tall and healthy males younger than 40 years old. Primary spontaneous pneumothorax has a recurrence rate of 20-30% after the first attack, 50% after the second attack, and 80% after the third attack. Surgery is presented as a treatment option to reduce the high recurrence rate after the second attack. It has been reported that recurrence is between 10 and 20% in patients who undergo bullectomy or wedge resection with endoscopic steps alone. Therefore, various pleural pleurodesis methods are applied in addition to bulla resection in order to reduce the recurrence rate after surgery. In mechanical pleurodesis, adhesion between visceral and parietal pleura is achieved by mechanical abrasion of the parietal pleura or by total or partial removal of the parietal pleura. In chemical pleurodesis, the visceral pleura is adhered to the parietal pleura by creating irritation in the pleura with chemical agents. In cases where pleurodesis was added, the recurrence rate was reported to be between 1.7 and 2.8%. Whether the pleurectomy, pleural mechanical or chemical abrasion methods performed with video-assisted thoracoscopic surgery is superior for preventing recurrence is still a matter of debate. In this article, we aimed to discuss the advantages and disadvantages of pleurodesis methods in the surgical treatment of primary spontaneous pneumothorax in the light of the literature.

scholarly journals Uniportal VATS technique for primary spontaneous pneumothorax: An analysis of 46 cases

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Hasan Oğuz Kapicibasi
Keyword(s):  
Spontaneous Pneumothorax ◽  
Surgical Intervention ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode ◽  
Histopathological Diagnosis ◽  
Air Leakage ◽  
Creative Commons ◽  
Duration Of Hospitalization

Objective: In the treatment of primary spontaneous pneumothorax (PSP), the influence of safety and applicability of uniportal video assisted thoracoscopic surgery (VATS) bullectomy/blebectomy and pleurectomy method were evaluated in 46 patients. Methods: Between November 2010 and January 2019, 46 patients (36 males, 10 females; mean age 24.2 years; range 16-36 years) undergoing uniportal video thoracoscopic bullectomy/blebectomy and apical pleurectomy for primary spontaneous pneumothorax were evaluated retrospectively at Canakkale Onsekiz Mart University (COMU). One patient underwent surgery for the second time after three months for contralateral pneumothorax and counted as two different patients, hence forty seven operations were performed in total. The cases were evaluated in terms of age, gender, comorbidity, duration of hospital stay, histopathological diagnosis, postoperative morbidity and mortality. Results: Right surgical intervention was performed in 20 cases (42.6%) and left surgical intervention in 27 cases (57.6%). A total of 15 (31.9%) surgical operations were performed during the first attack, 30 (63.8%) during the second attack and 2 (4.3%) during third and more attacks. There was prolonged air leakage in all patients operated during the first episode. All cases underwent wedge resection and pleurectomy with endoscopic stapes. None of the patients required thoracotomy. Postoperative drainage period was between 2-7 days (mean: 4.1) and the duration of hospitalization was between three to eight days. Postoperative pain and paraesthesia were observed in eight cases. Prolonged air leakage was observed in five cases. Conclusion: With video thoracoscopic uniportal technique, not only lung biopsy and resection but also bullectomy/blebectomy and pleurectomy operations can be performed safely in the treatment of PSP. In view of this information, minimally invasive techniques are seen as more advantageous than conventional techniques. doi: https://doi.org/10.12669/pjms.36.2.1556 How to cite this:Kapicibasi HO. Uniportal VATS technique for primary spontaneous pneumothorax: An analysis of 46 cases. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1556 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Postoperative Clinical Outcomes of Thoracoscopic Surgery under Local Anesthesia in Patients with Primary Spontaneous Pneumothorax

2021 ◽  
Vol 11 (4) ◽  
pp. 1468
Author(s):  
Eunji Kim ◽  
Chi-Seung Lee ◽  
Jeong Su Cho ◽  
Hoseok I ◽  
Yeong Dae Kim ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Clinical Outcomes ◽  
Local Anesthesia ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Operation Time ◽  
Postoperative Recurrence ◽  
Primary Spontaneous Pneumothorax ◽  
Anesthetic Technique

(1) Background: since the technologies of anesthesia and surgery were advanced, video-assisted thoracic surgery (VATS) under local anesthesia (LA) has been widely carried out and is considered a robust surgical technique to prevent the recurrence of pneumothorax in patients with recurrent primary spontaneous pneumothorax (PSP). In this study, postoperative clinical outcomes were compared to evaluate the feasibility and efficacy of VATS under LA compared with general anesthesia (GA) in patients with PSP. (2) Methods: 255 patients underwent wedge resection underwent VATS for PSP in our hospital from January 2014 to June 2019. Of them, 30 patients underwent the operation under LA and the others underwent the operation under GA. Except for the anesthesia method, the same surgical technique was adopted for all patients. All medical records were retrospectively reviewed. (3) Results: the total operation time and total hospital days were relatively shorter, post-chest tube drainage was significantly shorter (0.04), and visual analog scale (VAS) scores in the outpatient clinic were significantly lower in the LA group than in the GA group (p = 0.01). The incidence of postoperative recurrence after discharge in the LA group (3.3%) was also lower than in the GA group (18.67%) (p = 0.001). In the LA group, there were no cases of conversion to intubation. (4) Conclusions: our results showed relatively better clinical outcomes in VATS under LA with sedation than under GA in the treatment of PSP. Hence, LA with sedation can be considered as a robust anesthetic technique for VATS and as applicable in the surgical treatment of PSP.

Clinical Pathway for the Treatment of Primary Spontaneous Pneumothorax in a General Surgery Department

2005 ◽  
Vol 20 (5) ◽  
pp. 268-276 ◽  
Author(s):  
Víctor Soria ◽  
Antonio Coll ◽  
Benito Flores ◽  
Joana Miguel ◽  
José Antonio Torralba ◽  
...  
Keyword(s):  
General Surgery ◽  
Clinical Pathway ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
Surgery Department

Lung wedge resection improves outcome in stage I primary spontaneous pneumothorax

2004 ◽  
Vol 77 (5) ◽  
pp. 1802-1805 ◽  
Author(s):  
Martin Czerny ◽  
Andreas Salat ◽  
Tatjana Fleck ◽  
Wolfgang Hofmann ◽  
Daniel Zimpfer ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Wedge Resection ◽  
Primary Spontaneous Pneumothorax ◽  
Stage I
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