[Surgical management of primary spontaneous pneumothorax. A national survey of the Emerging Thoracic Surgery Group of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR)]. / Manejo quirúrgico del neumotórax espontáneo primario. Encuesta nacional del Grupo Emergente de Cirugía Torácica de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR).

Introduction: In February 2022, the Emerging Thoracic Surgery Group of the Spanish Society of Pneumology and Thoracic Surgery initiated a multicenter study on the surgical management of primary spontaneous pneumothorax (PSP). As a preliminary step, this survey was developed with the aim of finding out the current situation in our country to specify and direct this project. Method: A descriptive study was carried out based on the results of this survey launched through the Google Docs® platform. The survey was sent to all active national thoracic surgeons, a total of 319. It consisted of 20 questions including demographic, surgical and follow-up data. Results: We obtained 124 responses (39% of all specialists and doctors in training in the national territory). The most consistent indications were: homolateral recurrence for 124 (100%), lack of resolution of the episode for 120 (96.7%), risk professions for 104 (84%) and bilateral pneumothorax for 93 (75%). The approach of choice for 100% of respondents was videothoracoscopy. Of these, 96 contemplated pulmonary resection of obvious lesions (77%). Regarding the pleurodesis technique, pleural abrasion was the technique most used by 70 respondents (56.7%) while 49 (40%) performed chemical pleurodesis with talc either alone or in combination with mechanical pleurodesis. Conclusions: While there is some consistency in some aspects of surgical management of PSP, this survey makes evident the variability in pleurodesis techniques applied among surgeons in our country.

Experience and development of the video-assisted thoracic surgery lobectomy technique: comparative study with conventional surgery in stage I non-small cell lung cancer.

BACKGROUND: Surgical treatment of stage I non-small cell lung cancer (NSCLC) can be performed either by thoracotomy or by employing video-assisted thoracic surgery (VATS). The aim of this study was to compare long and short-term results of conventional surgery (CS) vs. VATS lobectomy in the treatment of stage I NSCLC. MATERIALS AND METHODS: We performed a retrospective, analytical study of patients undergoing surgery for stage I NSCLC during the period January 1993 to December 2005. The variables analyzed were overall survival, recurrence, distant metastasis, morbidity, mortality and hospital stay. During this period, 256 anatomic lung resections were performed: 141 by CS and 115 by VATS. RESULTS: There were statistically significant differences in: (i)mean hospital stay in patients with no complications (VATS group: 4.3 days vs. CS group: 8.7 days, P=.0001); (ii)mean hospital stay in patients with complications (VATS: 7.2 days vs. CS: 13.7 days, P=.0001), and (iii)morbidity (VATS: 15.6% vs. CS: 36.52%, P=.0001). No statistically significant differences were found in: (i)mortality (VATS: 2.17% vs. CS: 1.7%, P=.88); (ii)5-year overall survival (VATS: 68.1% vs. CS: 63.8%), and (iii) local recurrence and distant metastasis (P=.82). CONCLUSIONS: VATS lobectomy is a safe and effective approach, with a shorter hospital stay and lower morbidity than CS; no statistically significant differences were observed in survival in patients undergoing surgery for stage I NSCLC.

Experiencia y desarrollo de la técnica de lobectomía por cirugía torácica videoasistida: estudio comparativo con cirugía convencional en estadio i de cáncer de pulmón no microcítico / Experience and Development of the Video-Assisted Thoracic Surgery Lobectomy Technique: Comparative Study With Conventional Surgery in Stage I Non-Small Cell Lung Cancer

Objetivo: Analizar nuestra experiencia con la cirugía torácica videoasistida (VATS) y comparar sus resultados a corto y a largo plazo con la lobectomía por cirugía convencional, en el tratamiento quirúrgico del cáncer de pulmón no microcítico (CPNM) en estadio i . Material y métodos: Se realizó un estudio retrospectivo y analítico de los pacientes intervenidos de cáncer de pulmón no microcítico en estadio i durante el periodo de enero de 1993 a diciembre de 2005. Las variables analizadas fueron: supervivencia global, recidiva, metástasis a distancia, morbimortalidad y estancia hospitalaria. Durante este periodo se realizaron 256 resecciones pulmonares anatómicas: 141 por VATS y 115 por cirugía convencional. Resultados: Se encontraron diferencias estadísticamente significativa en: a) estancia media postoperatoria en pacientes que no tuvieron complicaciones (grupo VATS: 4,3 días; grupo de cirugía convencional: 8,7 días; p = 0,0001); b) estancia media postoperatoria en pacientes que tuvieron complicaciones (VATS: 7,2 días; cirugía convencional: 13,7 días; p = 0,0001), y c) morbilidad (VATS: 15,6%; cirugía abierta: 36,52%; p = 0,0001). No se encontraron diferencias estadísticamente significativas en: a) mortalidad (VATS: 2,17%; cirugía convencional: 1,7%; p = 0,88); b) supervivencia global a 5 años (VATS: 68,1%; cirugía convencional: 63,8%); c) recidiva local y metástasis a distancia (p = 0,82). Conclusiones: La lobectomía VATS es una técnica segura y eficaz, con una menor estancia hospitalaria y morbilidad que la cirugía convencional, sin que se observen diferencias estadísticamente significativas en la supervivencia en pacientes intervenidos por cáncer de pulmón no microcítico en estadio I

Background: Surgical treatment of stage I non-small cell lung cancer (NSCLC) can be performed either by thoracotomy or by employing video-assisted thoracic surgery (VATS). The aim of this study was to compare long and short-term results of conventional surgery (CS) vs. VATS lobectomy in the treatment of stage I NSCLC. Materials and methods: We performed a retrospective, analytical study of patients undergoing surgery for stage I NSCLC during the period January 1993 to December 2005. The variables analyzed were overall survival, recurrence, distant metastasis, morbidity, mortality and hospital stay. During this period,256 anatomic lung resections were performed: 141 by CS and 115 by VATS. Results: There were statistically significant differences in: (I) mean hospital stay in patients with no complications (VATS group: 4.3 days vs. CS group: 8.7 days, P = 0.0001); (ii) mean hospital stay in patients with complications (VATS: 7.2 days vs. CS: 13.7 days, P =0.0001), and (iii) morbidity (VATS: 15.6% vs. CS: 36.52%, P = 0.0001). No statistically significant differences were found in: (I) mortality (VATS: 2.17% vs. CS:1.7%, P = .88); (II) 5-year overall survival (VATS: 68.1% vs. CS: 63.8%), and (III) local recurrence and distant metastasis (P = 0.82). Conclusions: VATS lobectomy is a safe and effective approach, with a shorter hospital stay and lower morbidity than CS; no statistically significant differences were observed in survival in patients undergoing surgery for stage I NSCLC