Levent CANSEVER, Mehmet Zeki GÜNLÜOĞLU, Celalettin İbrahim KOCATÜRK, Ulaş ÇINAR, Akif TURNA, Servet ÖZDEMİR, BEDİRHAN Mehmet Ali

The results of wedge resection and partial pleurectomy in the surgical treatment of primary spontaneous pneumothorax: videothoracoscopy or axillary thoracotomy?

Amaç: Bu çalışmada primer spontan pnömotoraks (PSP) hastalarında video yardımlı torakoskopik cerrahi (VATS) ve aksiller torakotomi yaklaşımlarıyla yapılan kama rezeksiyon ve parsiyel plevrektominin sonuçları karşılaştırıldı. Çalışma planı: Ocak 2007 - Aralık 2008 tarihleri arasında kliniğimizde PSP nedeniyle 478 hasta tedavi edildi. Bu hastaların 101'ine stapler yardımıyla, 110 apikal kama rezeksiyonu ve apikal plevrektomi işlemi uygulandı. Bu işlemlerin 45'i VATS (grup V), 65'i aksiller torakotomi (grup T) yaklaşımıyla yapıldı. İki grup, işlem süresi, kullanılan stapler yükleme ünitesi sayısı, göğüs tüpü kalma süresi, ameliyat sonrası narkotik analjezik gereksinimi, ameliyat sonrası komplikasyonlar, tekrar ameliyat gereksinimi ve rekürens oranları açısından karşılaştırıldı. İstatistiksel analiz için Student t-testi, ki-kare testi ve Fisher kesinlik testi kullanıldı.Bulgular: Grup V ve grup T arasında yaş, cinsiyet, sigara alışkanlığı, pnömotoraks tarafı ve cerrahi endikasyonlar, ameliyat süresi, ameliyat sonrası göğüs tüpü kalma süresi, ameliyat sonrası komplikasyon oranı, tekrar ameliyat gereksinimi ve rekürens oranları açısından gruplar arasında anlamlı fark bulunmadı. Grup V'de beş hastada, grup T'de ise 20 hastada narkotik analjezik kullanma gereksinimi oluştu (p=0.02). Ameliyat sırasında kullanılan ortalama stapler yükleme ünitesi sayısı grup V'de 2.7, grup T'de ise 1.43 idi (p

Primer spontan pnömotoraksın cerrahi tedavisinde kama rezeksiyon ve parsiyel plevrektominin sonuçları: Videotorakoskopi mi aksiller torakotomi mi?

Background: In this study we compared the results of wedge resection and partial pleurectomy in primary spontaneous pneumothorax (PSP) patients treated using video-assisted thoracoscopic surgery (VATS) and axillary thoracotomy approaches. Methods: Four-hundred and seventy-eight patients were treated in our clinic for PSP between January 2007 and December 2008. We performed 110 apical wedge resections with a stapler and a partial pleurectomy in 101 patients. Fortyfive of the procedures were performed with VATS (group V) and 65 with axillary thoracotomy (group T) approaches. The two groups were compared with respect to the duration of the procedure, number of stapler reload units used, duration of chest tube, requirement for postoperative narcotic analgesics, postoperative complications, need for reoperation, and recurrence rate. Student's t-test, the chi-square test, and Fisher's exact test were used for the statistical analysis.Results: There were no significant differences between groups V and T in terms of age, gender, smoking habits, pneumothorax side, surgical indications, duration of surgery, postoperative duration of chest tube, postoperative complication rate, reoperation rate, or recurrence rate. Narcotic analgesics were needed in five cases in group V and 20 cases in group T (p=0.02). The mean number of stapler reload units used during the operation was 2.7 in group V and 1.43 in group T (p

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