| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2003;76:1661-1664
© 2003 The Society of Thoracic Surgeons
a Division of Cardiothoracic Surgery, George Washington University Medical Center, Washington, District of Columbia, USA
b Division of Cardiothoracic Surgery, Georgetown University Medical Center, Washington, District of Columbia, USA
c Division of Cardiothoracic Surgery, VAMC, Washington, DC, USA
* Address reprint requests to Dr Alexander, Cardiothoracic Surgery, 2150 Pennsylvania Ave, Suite 6B, Washington, DC 20037
e-mail: ealexander{at}mfa.gwu.edu
Presented at the Forty-eighth Annual Meeting of the Southern Thoracic Surgical Association, San Antoinio, TX, Nov 8–10, 2001.
BACKGROUND: The treatment of primary spontaneous pneumothorax in young adults has been controversial. Conventional treatment consisting of chest tube thoracostomy may be associated with morbidity at the time of tube insertion, prolonged hospitalization, and interval operation in many patients. As spontaneous pneumothorax in young adults is usually associated with apical blebs, we hypothesized that video-assisted thoracic surgical (VATS) resection of the blebs at the time of the first pneumothorax may be an effective treatment associated with low morbidity and short hospital stays.
METHODS: From July 1992 to February 2001, 156 young adults were treated for spontaneous pneumothorax. Within 12 hours of presentation to the emergency department patients underwent semielective VATS with bleb resection and pleuradesis. During follow-up patients were observed for recurrent pneumothorax.
RESULTS: There were 69 men (44%) and 87 women (56%). The median age was 19 years old (range 14 to 38 years old). Patients were predominantly tall and thin. Patients were mildly symptomatic at the time of presentation. Apical blebs were seen in all patients and the presence of blebs was confirmed in the pathologic specimen. In 23 patients bleeding was associated with bleb rupture. There were no postoperative air leaks. The mean hospital stay was 2.4 ± 0.5 days. Follow-up ranged from 2 to 96 months (median 62 months). There were no recurrences on the index side.
CONCLUSIONS: VATS resection of apical blebs is associated with low morbidity and short hospitalization and provides an attractive alternative to the conventional treatment of initial tube thoracostomy and possible interval repeat thoracostomy or operation. VATS may be an effective first line treatment for spontaneous pneumothorax in young adults. Due to the pathophysiology of this disease, patients should be closely followed for the occurrence of pneumothorax on the contralateral side.
This article has been cited by other articles:
|
|
 |
|
  A. Chambers and M. Scarci In patients with first-episode primary spontaneous pneumothorax is video-assisted thoracoscopic surgery superior to tube thoracostomy alone in terms of time to resolution of pneumothorax and incidence of recurrence? Interactive CardioVascular and Thoracic Surgery, December 1, 2009; 9(6): 1003 - 1008. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Kim, H. K. Kim, Y. H. Choi, and S. H. Lim Thoracoscopic bleb resection using two-lung ventilation anesthesia with low tidal volume for primary spontaneous pneumothorax. Ann. Thorac. Surg., March 1, 2009; 87(3): 880 - 885. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Marcheix, L. Brouchet, C. Renaud, Y. Lamarche, A. Mugniot, V. Benouaich, J. Berjaud, and M. Dahan Videothoracoscopic silver nitrate pleurodesis for primary spontaneous pneumothorax: an alternative to pleurectomy and pleural abrasion? Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1106 - 1109. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Cardillo, F. Carleo, L. Carbone, M. Di Martino, L. Salvadori, A. Ricci, L. Petrella, and M. Martelli Long-term lung function following videothoracoscopic talc poudrage for primary spontaneous recurrent pneumothorax Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 802 - 805. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K.-D. Cho, C.-B. Park, M.-S. Cho, U. Jin, D.-G. Cho, and C.-K. Kim Modification of Thoracoscopic Surgery for Spontaneous Pneumothorax Asian Cardiovasc Thorac Ann, December 1, 2006; 14(6): 472 - 475. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J-M. Tschopp, R. Rami-Porta, M. Noppen, and P. Astoul Management of spontaneous pneumothorax: state of the art. Eur. Respir. J., September 1, 2006; 28(3): 637 - 650. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-S. Chen, H.-H. Hsu, R. J. Chen, S.-W. Kuo, P.-M. Huang, P.-R. Tsai, J.-M. Lee, and Y.-C. Lee Additional Minocycline Pleurodesis after Thoracoscopic Surgery for Primary Spontaneous Pneumothorax Am. J. Respir. Crit. Care Med., March 1, 2006; 173(5): 548 - 554. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Cardillo, F. Carleo, R. Giunti, L. Carbone, S. Mariotta, L. Salvadori, L. Petrella, and M. Martelli Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: A single-institution experience in 861 cases J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 322 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Sawada, Y. Watanabe, and S. Moriyama Video-Assisted Thoracoscopic Surgery for Primary Spontaneous Pneumothorax: Evaluation of Indications and Long-term Outcome Compared With Conservative Treatment and Open Thoracotomy Chest, June 1, 2005; 127(6): 2226 - 2230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Sedrakyan, J. van der Meulen, J. Lewsey, and T. Treasure Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials BMJ, October 30, 2004; 329(7473): 1008. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
