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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 2002 April;43(2):259-62

THORACIC SECTION 

    ORIGINAL ARTICLES

Stapler blebectomy and pleural abrasion by video-assisted thoracoscopy for spontaneous pneumothorax

Casadio C. *, Rena O., Giobbe R., Rigoni R. *, Maggi G., Oliaro A.

From ­the Department of Thoracic Surgery University of Torino, San Giovanni Battista Hospital Torino, Italy
*Unit of Thoracic Surgery University of Eastern Piedmont “Avogadro”, Novara, Italy

Background. This ­study ­aims to eval­u­ate ­the effi­ca­cy of vid­eo-assist­ed tho­rac­os­cop­ic sur­gery (­VATS) pleu­rod­e­sis in ­the treat­ment of spon­ta­ne­ous pneu­moth­o­rax ­with par­tic­u­lar ref­er­ence to ­the post­op­er­a­tive peri­od ­and ­the ­rate of recur­rence ­after pleu­ral abra­sion.
Methods. One hun­dred and thir­ty-­three ­patients ­who under­went ­VATS man­age­ment of pri­mary spon­ta­ne­ous pneu­moth­o­rax ­were ret­ro­spec­tive­ly ­reviewed. They ­were 113 ­males ­and 20 ­females ­with ­median ­age of 26 (­range 12-37). Among ­these ­patients, 114 under­went ­VATS ­for recur­rent pneu­moth­o­rax ­and 19 ­for per­sis­tent ­air-leak­age at ­the ­first epi­sode. During sur­gi­cal pro­ce­dure, in 78% of cas­es, paren­chy­mal ­blebs ­were iden­ti­fied ­and resect­ed by sta­pler resec­tion. All ­patients ­were sub­mit­ted to pleu­ral abra­sion.
Results. No ­intra- or post­op­er­a­tive ­deaths ­occurred. Postoperative com­pli­ca­tions ­were per­sis­tent ­air-­leak ­for ­more ­than 7 ­days in 6 ­patients (4.3%) bleed­ing in 3 ­patients (2.2%). The ­median ­chest-­tube dura­tion ­and hos­pi­tal ­stay ­were 2 (­range 2-11) ­and 3 (­range 3-12) ­days, respec­tive­ly. Median fol­low-up peri­od of 53 (­range 6-96) ­months ­was com­plete ­for ­all ­patients. Five epi­sodes of recur­rent pneu­moth­o­rax ­were encoun­tered ­and 4 of ­them, ­because of ­major ­entity, ­required re-do ­VATS ­with sta­pler resec­tion ­and pleu­ral abra­sion: ­their post­op­er­a­tive peri­od ­and resid­u­al fol­low-up ­was unevent­ful.
Conclusions. The ­goal in ­the sur­gi­cal man­age­ment of spon­ta­ne­ous pneu­moth­o­rax, ­which ­often ­affects “appar­ent­ly ­healthy” ­young ­patients, is to ­secure ­the ­less recur­rence ­rate ­with no mor­tal­ity ­and ­quite ­null mor­bid­ity ­and func­tion­al impair­ment. ­VATS sta­pler resec­tion ­and pleu­ral abra­sion is a ­safe pro­ce­dure allow­ing a ­good man­age­ment of ­the dis­ease ­with ­low com­pli­ca­tion ­rate, ­short ­chest-­drain dura­tion, hos­pi­tal ­stay ­and recur­rence ­rate ­quite sim­i­lar to ­those ­referred ­for oth­er pro­ce­dures ­such as pleu­ral pou­drage or lim­it­ed pleu­rec­to­my.

language: English


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