Young ADULTS, Rauf GÖRÜR, Ali KUTLU, Güner SÖNMEZ, Nurettin YİĞİT, Fatih CANDAŞ, Erdoğan Kunter KUNTER, Turgut ISITMANGİL

Retrospective Analysis Of Treatment Options In First Recurrences Of Primary Spontaneous Pneumothorax In Young Adults

Anahtar Kelimeler:

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Retrospective Analysis Of Treatment Options In First Recurrences Of Primary Spontaneous Pneumothorax In Young Adults

Aim: Surgical approach in the treatment of primary spontaneous pneumothorax (PSP) is still not well defined. We aimed to evaluate treatment options in first recurrences of PSP. Methods: We treated 44 male patients with first recurrences of PSP. All cases had been treated with chest tube for the first attack. In first recurrences, treatment strategies were classified into three groups such as chest tube (n:15, mean age 25.4±9.1), VATS (n:14, mean age 24.4±1.91) and open thoracotomy (n:15, mean age 23.2±3.1). These cases were retrospectively evaluated in terms of recurrence and succes rates. Results: There was no conversion to open thoracotomy in VATS series. VATS group had significant difference in terms of mean time to removal of chest tube when compared to chest tube and thoracotomy groups (p=0,042 and p=0,018 respectively). Also recurrences occurred in chest tube group (n:8), no recurrence was seen in thoracotomy and VATS groups. Conclusion: The present study strongly suggests VATS for management of first recurrences of PSP following pleural abrasion

Keywords:

Spontaneous pneumothorax, chest tube, thoracoscopy thoracotomy,

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Ong ME, Chan YH, Kee TY et al. Spontaneous pneumothorax outcome study (SPOT phase I): a 2-year review. Eur J Emerg Med 2004;11:89-94
Chen JS, Hsu HH, Kuo SW et al. Effects of additional minocycline pleurodesis after thoracoscopic procedures for primary spontaneous pneumothorax. Chest 2004;125:50-5
Morimoto T, Shimbo T, Noguchi Y et al. Effects of timing of thoracoscopic surgery pneumothorax on prognosis and costs. spontaneous Am J Surg 2004;187:767-74
Choudhary AK, Sellars ME, Wallis C et al. Primary spontaneous pneumothorax in children: the role of CT in guiding management. Clin Radiol 2005;60:508-11
Light RW. Manual aspiration: the preferred primary spontaneous pneumothorax? Am.J.Respir.Crit Care Med 2002;165: 1202-03 for managing
Cardillo G, Facciolo F, Giunti R et al. Videothoracoscopic treatment of primary spontaneous pneumothorax: a 6-year experience. Ann Thorac Surg 2000;69: 357-61
Hazama K, Akashi A, Shigemura N, Nakagiri T. Less invasive needle thoracoscopic laser ablation of small bullae pneumothorax. Eur J Cardiothorac Surg 2003;24:139-44 spontaneous
Ayed AK. Bilateral video-assisted thoracoscopic surgery for bilateral spontaneous 2002;122:2234-37 Chest
Doddoli C, Barlesi F, Fraticelli A et al. Video-assisted thoracoscopic management of recurrent primary spontaneous pneumothorax after prior talc pleurodesis: a feasible, safe and efficient treatment option. Eur J Cardiothorac Surg 2004;26:889-92
Naunheim KS, Mack MJ, Hazelrigg SR et al. Safety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax. J Thorac Cardiovasc Surg 1995;109: 1198-203
Hsu CC, Wu YL, Lin HJ et al. Indicators of haemothorax in patients with spontaneous pneumothorax. Emerg Med J 2005;22:415-17
Lang-Lazdunski L, de K, X, Pons F, Jancovici R. Primary spontaneous pneumothorax: one-stage treatment by bilateral videothoracoscopy. Ann Thorac Surg 2000;70:412-17
Tagaya N, Kasama K, Suzuki N et al. Video-assisted bullectomy using needlescopic instruments for spontaneous pneumothorax. Surg Endosc 2003;17: 1486-87
Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg 2005;28:43-46