Primer spontan pnömotoraks tedavisinde torakoskopinin alternatifi olarak transaksiller mini torakotomi: Prospektif kohort çalışma

Amaç: Primer spontan pnömotoraks tedavisinde uygulanan geleneksel açık cerrahi ve endoskopik yaklaşımların sonuçları karşılaştırılmaya devam etmektedir. Bu çalışma torakoskopinin alternatifi olarak kabul edilen transaksiller mini torakotominin etkinliğini belirlemeyi hedeflemektedir.Yöntemler: 2012 ile 2018 tarihleri arasında pnömotoraks nedeniyle 3-port torakoskopi ve transaksiller mini torakotomi uygulanmış olan 40’ar hastayı içeren bir çalışma yürütüldü. İki farklı cerrahi tipi yaş, cinsiyet, ameliyat tarafı, hastanede kalış süresi, komplikasyonlar, nüks ve toplam maliyet açısından karşılaştırıldı.Bulgular: Tüm grupta 68 (%85) erkek ve 12 (%15) kadın hasta vardı. Ortalama yaş 25 (3,96) (aralık: 18-35) yıl idi. Pnömotoraks 42 (%52.5) hastada sağ tarafta saptandı. Ortalama hastanede kalış süresi 2,86 (0,56) (aralık: 2-4) gün olarak hesaplandı. Hasta başına ortalama 3263,75 (563,71) TL masraf yapıldı. Toplam 11 (%13,75) hastada komplikasyon gelişirken 4 (%5) hastada nüks saptandı. Farklı cerrahi yapılan grupları arasında yaş, cinsiyet, ameliyat tarafı, hastanede kalış süresi ile komplikasyon ve nüks oranları açısından istatistiksel olarak anlamlı fark yokken maliyet torakotomi grubunda belirgin olarak düşüktü.Sonuç: Spontan pnömotoraks tedavisinde benzer cerrahi sonuçları ve daha düşük maliyeti göz önüne alındığında transaksiller mini torakotomi torakoskopiye alternatif olarak güvenle tercih edilebilir.

Anahtar Kelimeler:

Video yardımlı göğüs cerrahisi, Transaksiller mini torakotomi, Spontan pnömotoraks, Maliyet

Transaxillary mini thoracotomy as an alternative to thoracoscopy in the treatment of primary spontaneous pneumothorax: A prospective cohort study

Aim: Arguments comparing the outcomes of traditional open surgery and endoscopic approach performed for the treatment of primary spontaneous pneumothorax persist. This study aims to reveal the efficiency of transaxillary mini thoracotomy which is considered an alternative to thoracoscopy.Methods: This study was conducted with 40 patients who underwent 3-port thoracoscopy and 40 patients who were treated with transaxillary mini thoracotomy for pneumothorax between 2012 and 2018. Two different types of surgery were compared in terms of age, gender, side of operation, duration of hospital stay, complications, recurrence and total cost.Results: The whole group included 68 (85%) males and 12 (15%) females. Mean age was 25 (3.96) (range: 18-35) years. Pneumothorax was right sided in 42 (52.5%) patients. Mean hospital stay was 2.86 (0.56) (range: 2-4) days. Average cost was 3263.75 (563.71) TL per patient. Complications occurred in 11 (13.75%) patients whereas 4 (5%) cases developed recurrence. Groups of different surgeries had no statistically significant difference in terms of age, gender, side of operation, duration of hospital stay, rates of complication and recurrence while the average of cost was significantly lower for thoracotomy group.Conclusion: Regarding the identical surgical outcomes and lower cost, transaxillary mini thoracotomy can be safely preferred as an alternative to thoracoscopy for the treatment of spontaneous pneumothorax.

Keywords:

Video-assisted thoracic surgery, Transaxillary mini thoracotomy, Spontaneous pneumothorax, Cost,

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