Underlying Etiologic Factor of Recurrent Pneumothorax after Bullectomy / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery
; : 556-560, 1999.
Article
em Ko
| WPRIM
| ID: wpr-182581
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
The cause of spontaneous pneumothorax is not yet but it is certain that intrathoracic air comes from ruptured bulla. Video-assisted thoracoscopic surgery(VATS) or open thoracotomy is recommended for thoracic incision in recurrent pneumothorax. However, recurrent rate after bullectomy with the VATS is very high compared to mini-thoracotomy, 3% to 20% and below 2%, respectively. MATERIAL ANDMETHOD:
This retrospective analysis was performed on 16 re-operated cases among 446 surgically treated pneumothorax of the 737 cases of spontaneous pneumothorax diagnosed at Yongdong Severance Hospital from Nov. 1992 to June 1997.RESULT:
Among the 446 surgically-treated patients in 737 case of spontaneous pneumothorax, 16 patients underwent re-operation, showing a 3.5% re-operation rate. Male-to-female ratio was 15 to 1 and mean age at initial attack was 20.2 years(ranging from 15 to 50). Mean hospital stay was 6.34 days(ranging from 2 to 20 days) and mean chest tube indwelling period was 4.2 days(ranging from 1-10 days). Median follow-up was 46 months(range 10-66 months). Three different surgical methods were applied video-assisted thoracoscopic surgery(VAST) in 281 cases, of whom 2 underwent local anesthesia; subaxillary mini-thoracotomy in 159 cases and limited lateral thoracotomy in the remaining 6 cases. Three different re-operative surgical methods were applied ; video-assisted thoracoscopic surgery (VAST) in 6 cases, subaxillary mini-thoracotomy in 9 cases, and limited lateral thoracotomy in the remaining 1 case. The underlying etiological factors of the recurrent pneumothorax after bullectomy were o erlooking type(9) and new growing type(7). Mean recurrent period from previous operation was 1 month for overlooking type and 18 months for new growing type.CONCLUSION:
The underlying etiological factors of recurrent pneumothorax lead to re-operation were new-growing and over-looking type. We need additional treatments besides resecting blebs of prevent the recurrence rate and more gentle handling with forceps due to less damage to the pleura.Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Pleura
/
Pneumotórax
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Recidiva
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Reoperação
/
Instrumentos Cirúrgicos
/
Toracotomia
/
Tubos Torácicos
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Estudos Retrospectivos
/
Seguimentos
/
Vesícula
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Idioma:
Ko
Revista:
The Korean Journal of Thoracic and Cardiovascular Surgery
Ano de publicação:
1999
Tipo de documento:
Article