Hitoshi Igai1, Mitsuhiro Kamiyoshihara2, Takashi Ibe2, Natsuko Kawatani2, Kimihiro Shimizu3. 1. Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma, 371-0014, Japan. hitoshi-iga@hotmail.co.jp. 2. Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma, 371-0014, Japan. 3. Gunma University Graduate School of Medicine, Maebashi, Japan.
Abstract
OBJECTIVES: Our objective was to evaluate the validity of surgery for secondary spontaneous pneumothorax (SSP) by comparison with other treatments or with perioperative results for primary spontaneous pneumothorax (PSP). METHODS: Between January 2009 and March 2015, 144 patients with SSP, aged 60 years or over, were treated in our institution. We reviewed the patients' characteristics, perioperative results, and relapse rate. Treatment to arrest air-leakage included surgery (n = 79), drainage only (n = 30), and pleurodesis (n = 35), and the pneumothorax relapse rate or mortality before discharge was compared for each. Additionally, we compared the perioperative results or relapse rate between SSP (n = 70) and PSP (n = 70) in patients who underwent 3-port thoracoscopic surgery. RESULTS: There was a significant difference in the relapse rate between the surgery and non-surgery groups (5.3 vs. 27.4 %, p = 0.0006). However, no significant difference in mortality before discharge was determined (p = 0.66). Significant differences were identified between the SSP and PSP groups for operation time, duration of chest drainage, and the length of postoperative hospitalization, and the postoperative morbidity were greater in the SSP group (p < 0.0001 for all). However, there was no significant difference in postoperative 30-day mortality or the relapse rate (p = 0.5, p = 0.68, respectively). CONCLUSIONS: Surgical treatment under general anesthesia for SSP is effective for arresting persistent air leaks or avoiding pneumothorax relapse, compared with drainage or pleurodesis, and is feasible if the appropriate perioperative management is performed.
OBJECTIVES: Our objective was to evaluate the validity of surgery for secondary spontaneous pneumothorax (SSP) by comparison with other treatments or with perioperative results for primary spontaneous pneumothorax (PSP). METHODS: Between January 2009 and March 2015, 144 patients with SSP, aged 60 years or over, were treated in our institution. We reviewed the patients' characteristics, perioperative results, and relapse rate. Treatment to arrest air-leakage included surgery (n = 79), drainage only (n = 30), and pleurodesis (n = 35), and the pneumothorax relapse rate or mortality before discharge was compared for each. Additionally, we compared the perioperative results or relapse rate between SSP (n = 70) and PSP (n = 70) in patients who underwent 3-port thoracoscopic surgery. RESULTS: There was a significant difference in the relapse rate between the surgery and non-surgery groups (5.3 vs. 27.4 %, p = 0.0006). However, no significant difference in mortality before discharge was determined (p = 0.66). Significant differences were identified between the SSP and PSP groups for operation time, duration of chest drainage, and the length of postoperative hospitalization, and the postoperative morbidity were greater in the SSP group (p < 0.0001 for all). However, there was no significant difference in postoperative 30-day mortality or the relapse rate (p = 0.5, p = 0.68, respectively). CONCLUSIONS: Surgical treatment under general anesthesia for SSP is effective for arresting persistent air leaks or avoiding pneumothorax relapse, compared with drainage or pleurodesis, and is feasible if the appropriate perioperative management is performed.
Authors: Kasra Shaikhrezai; Alexandra I Thompson; Caroline Parkin; Steven Stamenkovic; William S Walker Journal: Eur J Cardiothorac Surg Date: 2010-11-27 Impact factor: 4.191
Authors: Andrea Imperatori; Nicola Rotolo; Marco Spagnoletti; Luigi Festi; Fabio Berizzi; Davide Di Natale; Elisa Nardecchia; Lorenzo Dominioni Journal: Interact Cardiovasc Thorac Surg Date: 2015-02-16