Agata Dżeljilji1, Krzysztof Karuś1, Artur Kierach2, Barbara Kazanecka3, Wojciech Rokicki4, Witold Tomkowski3. 1. Department of Thoracic Surgery, National Institute of Tuberculosis and Lung Diseases (NITLD), Warsaw, Poland. 2. Kierach Clinic, Tychy, Poland. 3. Cardio-Pulmonary Intensive Care Department, National Institute of Tuberculosis and Lung Diseases (NITLD), Warsaw, Poland. 4. Department of Thoracic Surgery, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
Abstract
BACKGROUND: The treatment of primary spontaneous pneumothorax (PSP) remains controversial. Guidelines do not explicitly define surgical procedures. Different treatment modalities are observed in clinics of same profile. Treatment is controversial. The aim of the work was to compare the effectiveness of two methods-pleurectomy and pleurectomy combined with wedge resection in patients with PSP in terms of safety and efficiency. METHODS: Non-randomized observational study based on clinical analysis of 73 patients, M:F ratio 3:1, aged 18 to 45 years, the average age was 29 years, operated between January 2008 and December 2014 due to the occurrence of PSP. Pleurectomy was supplemented by wedge resection in patients diagnosed intraoperatively with ELC (emphsema-like changes) ≥ III stage (classification of PSP by Vanderschueren). Efficacy was defined as follows: complete lung expansion, drainage (days), air leak, frequency of PAL (persistent air leak >5 days), recurrences and re-operations. Safety was defined as follows: heamothorax, major bleeding (loss of Hg >2 g/dL), infections, deaths. The research project was approved by the Bioethical Commission of the Silesian Medical University in Katowice (KNW/022/kb1/3/14). RESULTS: Mean follow-up was 22 months. Efficacy: recurrences occurred less frequently in group treated with pleurectomy without wedge resection. No results were found in other parameters. Safety: No results were found in all parameters. CONCLUSIONS: Efficacy and safety of pleurectomy vs. pleurectomy + wedge resection is comparable. 2019 Journal of Thoracic Disease. All rights reserved.
BACKGROUND: The treatment of primary spontaneous pneumothorax (PSP) remains controversial. Guidelines do not explicitly define surgical procedures. Different treatment modalities are observed in clinics of same profile. Treatment is controversial. The aim of the work was to compare the effectiveness of two methods-pleurectomy and pleurectomy combined with wedge resection in patients with PSP in terms of safety and efficiency. METHODS: Non-randomized observational study based on clinical analysis of 73 patients, M:F ratio 3:1, aged 18 to 45 years, the average age was 29 years, operated between January 2008 and December 2014 due to the occurrence of PSP. Pleurectomy was supplemented by wedge resection in patients diagnosed intraoperatively with ELC (emphsema-like changes) ≥ III stage (classification of PSP by Vanderschueren). Efficacy was defined as follows: complete lung expansion, drainage (days), air leak, frequency of PAL (persistent air leak >5 days), recurrences and re-operations. Safety was defined as follows: heamothorax, major bleeding (loss of Hg >2 g/dL), infections, deaths. The research project was approved by the Bioethical Commission of the Silesian Medical University in Katowice (KNW/022/kb1/3/14). RESULTS: Mean follow-up was 22 months. Efficacy: recurrences occurred less frequently in group treated with pleurectomy without wedge resection. No results were found in other parameters. Safety: No results were found in all parameters. CONCLUSIONS: Efficacy and safety of pleurectomy vs. pleurectomy + wedge resection is comparable. 2019 Journal of Thoracic Disease. All rights reserved.
Authors: Martin Czerny; Andreas Salat; Tatjana Fleck; Wolfgang Hofmann; Daniel Zimpfer; Franz Eckersberger; Walter Klepetko; Ernst Wolner; Michael-Rolf Mueller Journal: Ann Thorac Surg Date: 2004-05 Impact factor: 4.330
Authors: Marc Noppen; Tom Dekeukeleire; Shane Hanon; Grigoris Stratakos; Kayvan Amjadi; Priscilla Madsen; Marc Meysman; Jan D'Haese; Walter Vincken Journal: Am J Respir Crit Care Med Date: 2006-04-20 Impact factor: 21.405