If Background Lung Abnormalities Do Not Affect the Presentation of Spontaneous Pneumothorax, Is Lung Resection Always Justified?
J Bronchology Interv Pulmonol
; 24(3): 225-231, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-28538019
ABSTRACT
BACKGROUND:
The suggestion that spontaneous pneumothorax (SP) may result from diffuse porosity rather than discrete anatomic abnormality challenges the practice of targeted bullectomy. We assessed whether underlying pulmonary abnormalities are correlated or could be predicted from the mode of presentation, with potential implications for treatment.METHODS:
We analyzed 192 consecutive video-assisted thoracoscopic surgery resections for SP (139 primary, 53 secondary) in 171 patients (115 male, age 36, range, 16 to 81). Presentation was categorized as recurrent never drained (RND), recurrent drained, persistent air leak (PAL). Resected lung pathology was categorized as no bleb/bulla, ruptured bleb/bulla, unruptured bleb/bulla.RESULTS:
No correlation between presentation and resected lung pathology was observed for primary (P=0.608) or secondary SP (P=0.597). A similar proportion of patients in each pathologic group presented with PAL or RND; ruptured bleb/bulla or no bleb/bulla was equally noted in PAL and RND group.CONCLUSIONS:
There is lack of association between resected lung pathology and mode of presentation. This suggests that discrete anatomic abnormalities may not be responsible for the air leak leading to pneumothorax. In conjunction with favorable reported outcomes from medical thoracoscopy and talc pleurodesis alone, these findings challenge the current practice of routine video-assisted thoracoscopic surgery lung resection in these patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pneumotórax
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Técnicas de Apoio para a Decisão
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Pulmão
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Bronchology Interv Pulmonol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido