scholarly journals Fulminant Unilateral Pulmonary Edema After Insertion of a Chest Tube – a Complication After a Primary Spontaneous Pneumothorax: Undiagnosed Takotsubo Cardiomyopathy?

2009 ◽  
Author(s):  
Barbara Khanavkar
Keyword(s):  
Pulmonary Edema ◽  
Takotsubo Cardiomyopathy ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
Unilateral Pulmonary Edema

scholarly journals The influence of chest tube size and position in primary spontaneous pneumothorax

2017 ◽  
Vol 9 (2) ◽  
pp. 327-332 ◽  
Author(s):  
Sara S. Riber ◽  
Lars P. S. Riber ◽  
Winnie H. Olesen ◽  
Peter B. Licht
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
Tube Size

scholarly journals Two-port versus three-port video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: feasibility, postoperative outcome and long-term recurrence rates

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephen Fung ◽  
Hany Ashmawy ◽  
Sami Safi ◽  
Anja Schauer ◽  
Alexander Rehders ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Postoperative Outcome ◽  
Primary Spontaneous Pneumothorax ◽  
Recurrence Rates

Abstract Background Two-port VATS (2-P-VATS) and three-port VATS (3-P-VATS) are well-established techniques for surgical therapy of primary spontaneous pneumothorax (PSP). However, comparisons of both techniques in terms of postoperative outcome and recurrence are limited. Methods From January 2010 to March 2020, we retrospectively reviewed data of 58 PSP patients who underwent VATS in our institution. For statistical analysis, categorical and continuous variables were compared by chi-square test or Fisher’s exact test and the Student´s t-test, respectively. Twenty-eight patients underwent 2-P-VATS and 30 were treated with 3-P-VATS. Operation time, length of hospital stay (LOS), total dose of analgesics per stay (opioids and non-opioids), duration of chest tube drainage, pleurectomy volume (PV), postoperative complications and recurrence rates were compared between both groups. Results Clinical and surgical characteristics including mean age, gender, Body-Mass-Index (BMI), pneumothorax size, smoking behaviour, history of contralateral pneumothorax, side of pneumothorax, pleurectomy volume and number of resected segments were similar in both groups. The mean operation time, LOS and total postoperative opioid and non-opioid dose was significantly higher in the 3-P-VATS group compared with the 2-P-VATS group. Despite not being statistically significant, duration of chest tube was longer in the 3-P-VATS group compared with the 2-P-VATS group. In terms of postoperative complications, the occurrence of hemothorax was significantly higher in the 3-P-VATS group (3-P-VATS vs. 2-P-VATS; p = 0.001). During a median follow-up period of 61.6 months, there was no significant statistical difference in recurrence rates in both groups (2/28 (16.7%) vs. 5/30 (7.1%); p = 0.274). Conclusion Our data demonstrate that 2-P-VATS is safer and effective. It is associated with reduced length of hospital stay and decreased postoperative pain resulting in less analgesic use.

scholarly journals Chest tube drainage versus video-assisted thoracoscopic surgery for a first episode of primary spontaneous pneumothorax: a systematic review and meta-analysis

2019 ◽  
Vol 56 (5) ◽  
pp. 819-829
Author(s):  
Jean H T Daemen ◽  
Pieter W J Lozekoot ◽  
Jos G Maessen ◽  
Michiel H M Gronenschild ◽  
Gerben P Bootsma ◽  
...  
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Meta Analysis ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Tube Drainage ◽  
Recurrence Rates ◽  
Tube Drainage ◽  
Ipsilateral Recurrence ◽  
Length Of Hospitalization

Summary Primary spontaneous pneumothorax affects up to 28 patients per 100 000 population yearly and is commonly resolved by chest tube drainage. However, drainage is also known to be associated with ipsilateral recurrence rates ranging from 25% to 43%. Preventive video-assisted thoracoscopic surgery (VATS) may be an effective alternative to diminish these recurrence rates and its associated morbidity. The aim of this study was to compare the efficacy of chest tube drainage and VATS as first line treatments of an initial episode of primary spontaneous pneumothorax. The MEDLINE, EMBASE, CENTRAL and Clinicaltrials.gov databases were searched through 16 September 2018. Data regarding the ipsilateral recurrence rate and the length of hospitalization were extracted and submitted to meta-analysis using the random-effects model and the I2 test for heterogeneity. Two randomized controlled trials and 2 observational studies were included, enrolling a total of 479 patients. Pairwise analysis demonstrated significantly reduced ipsilateral recurrence rates [odds ratio 0.15, 95% confidence interval (CI) 0.07–0.33; P < 0.00001] and length of hospitalization (standardized mean difference −2.19, 95% CI −4.34 to −0.04; P = 0.046) in favour of VATS. However, a significant level of heterogeneity was detected for the length of hospitalization (I2 = 97%; P < 0.00001). Subgroup analysis that stratified study design found no statistical differences regarding recurrence rate. In conclusion, VATS can be an effective and attractive alternative to standard chest tube drainage, with reduced ipsilateral recurrence rates and length of hospitalization. However, given the low quality of the majority of included studies, more well-designed randomized controlled trials are necessary to strengthen the current evidence.

European Pediatric Surgeons' Association Survey on the Management of Primary Spontaneous Pneumothorax in Children

2021 ◽  
Author(s):  
Tutku Soyer ◽  
Anne Dariel ◽  
Jens Dingemann ◽  
Leopoldo Martinez ◽  
Alessio Pini-Prato ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Chest Tube ◽  
Open Surgery ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode ◽  
Tube Insertion ◽  
Recurrent Pneumothorax ◽  
Chest Tube Insertion ◽  
Pleural Abrasion

Abstract Aim To evaluate the practice patterns of the European Pediatric Surgeons' Association (EUPSA) members regarding the management of primary spontaneous pneumothorax (PSP) in children. Methods An online survey was distributed to all members of EUPSA. Results In total, 131 members from 44 countries participated in the survey. Interventional approach (78%) is the most common choice of treatment in the first episode, and most commonly, chest tube insertion (71%) is performed. In the case of a respiratory stable patient, 60% of the responders insert chest tubes if the pneumothorax is more than 2 cm. While 49% of surgeons prefer surgical intervention in the second episode, 42% still prefer chest tube insertion. Main indications for surgical treatment were the presence of bullae more than 2 cm (77%), and recurrent pneumothorax (76%). Eighty-four percent of surgeons prefer thoracoscopy and perform excision of bullae with safe margins (91%). To prevent recurrences, 54% of surgeons perform surgical pleurodesis with pleural abrasion (55%) and partial pleurectomy (22%). The responders who perform thoracoscopy use more surgical pleurodesis and prefer shorter chest tube duration than the surgeons performing open surgery (p < 0.05). Conclusion Most of the responders prefer chest tube insertion in the management of first episode of PSP and perform surgical treatment in the second episode in case of underlying bullae more than 2 cm and recurrent pneumothorax. The surgeons performing thoracoscopy use more surgical pleurodesis and prefer shorter chest tube duration than the responders performing open surgery. The development of evidence-based guidelines may help standardize care and improve outcomes in children with PSP.

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