Chest
Minimally Invasive TechniquesVideo-Assisted Thoracoscopic Surgery for Primary Spontaneous Pneumothorax: Evaluation of Indications and Long-term Outcome Compared With Conservative Treatment and Open Thoracotomy
Section snippets
Patients Characteristics and Treatment Protocol
This retrospective study was carried out by reviewing medical records. Between January 1989 and April 2001, 281 consecutive patients were referred with a diagnosis of primary spontaneous pneumothorax. History of pneumothorax and treatment method were carefully reviewed. All of this information was added to our data and evaluated in this study.
Our treatment diagram is shown in Figure 1. Before November 1993 (previous to induction of VATS), conservative treatment, including observation,
Results
During this study period, 281 patients (255 male and 26 female) were referred to our hospital with primary spontaneous pneumothorax. The mean (± SD) age was 29.1 ± 13.6 (range, 5 to 79 years). The right lung was involved in 127 patients, and left lung was involved in 154 patients. Data were evaluated on July 2002. The mean follow-up period was 78.3 months (range, 13 to 163 months).
A summary of clinical courses and treatments of all 281 patients in shown in Table 1. Recurrences were observed in
Discussion
Spontaneous primary pneumothorax has traditionally been managed by conservative treatment including observation and tube thoracotomy. Only in cases of prolonged air leakage and recurrence was a surgical procedure considered. However, since the initiation of VATS, it seems that the treatment of primary spontaneous pneumothorax has been changed dramatically. Many investigators10111213 have reported its usefulness and safety. However, there are still some issues to be discussed: (1) might VATS
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Association of initial management on readmissions for spontaneous pneumothorax in adolescents
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2020, Journal of Surgical ResearchCitation Excerpt :Quality improvement and single-institution retrospective studies have shown that those treated with early surgical intervention with VATS during their initial presentation tend to have a shorter length of stay (LOS) compared with those treated with a chest tube or no intervention.3 It remains difficult to ascertain which patients should be stratified to a high recurrence risk group as 45%-78% of these children may never have a recurrence at all.2,4-7 As a result, this management is not commonplace with less than one in 20 pediatric surgeons currently offering an upfront VATS at the initial presentation.8
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