Videothoracoscopic treatment of primary spontaneous pneumothorax: a 6-year experience.
Ann Thorac Surg
; 69(2): 357-61; discussion 361-2, 2000 Feb.
Article
en En
| MEDLINE
| ID: mdl-10735663
ABSTRACT
BACKGROUND:
Timing and surgical approach in the treatment of primary spontaneous pneumothorax (PSP) are not well defined. The objective of this study is to propose a treatment protocol by videothoracoscopy (VATS) in PSP.METHODS:
From July 1992 to May 1998, 432 patients underwent VATS treatment of PSP. Indications were recurrent ipsilateral pneumothorax 322 cases; persistent air leak following a first episode 93 patients; recurrence following VATS 16 cases; recurrence following thoracotomy 1 patient. Vanderschueren's classification was used for staging. Surgical indications were stages I and II, subtotal pleurectomy or talc poudrage; stages III and IV, stapling or ligation of the bullae and subtotal pleurectomy or talc poudrage. Differences in recurrence rates were calculated to compare the specific procedures.RESULTS:
No postoperative deaths occurred. Complication rate was 4.16%. Conversion rate was 2.3%. Mean follow-up was 38 months (2 to 72 months). Overall recurrence rate was 4.4%. Specific recurrence rates following stapling and talc poudrage were, respectively, 1.27% and 1.79%. Talc poudrage and stapling of the bullae are respectively superior to subtotal pleurectomy (p < 0.0001) and ligation (p < 0.0001).CONCLUSIONS:
Stapling of the bullae and talc poudrage by VATS represent the treatment of choice of PSP.
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Bases de datos:
MEDLINE
Asunto principal:
Neumotórax
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Cirugía Torácica Asistida por Video
Tipo de estudio:
Guideline
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Observational_studies
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Prognostic_studies
Límite:
Adolescent
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Adult
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Aged
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Thorac Surg
Año:
2000
Tipo del documento:
Article
País de afiliación:
Italia