Thoracoscopic or open pleurectomy for spontaneous pneumothorax ? a common question about a common problem | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2001]

Author(s):

1. Rizwan Qureshi: Department of Cardiothoracic Surgery, Walsgrave Hospital, Coventry, United Kingdom

2. Ann Nugent: Department of Cardiothoracic Surgery, Walsgrave Hospital, Coventry, United Kingdom

3. Richard Norton: Department of Cardiothoracic Surgery, Walsgrave Hospital, Coventry, United Kingdom

Abstract:

To analyse and compare the efficiency of video-assisted thoracoscopic surgery (VATS) and open pleurectomy for spontaneous pneumothorax. Design: Retrospective cohort of patients who underwent VATS/open pleurectomy for spontaneous pneumothorax. Place and Duration of Study: This study was carried out at Walsgrave Hospital Coventry, U.K over a period of 5 years. Subjects and Methods: Fifty-seven patients, 36 males and 21 females were studied. Thirty-one patients underwent open pleurectomy with median age of 36.45 years. VATS pleurectomy was carried out on 26 patients with median age of 40.03 years. The operative time, amount of analgesia used on the first five days, the duration and drainage of chest, hospital stay and recurrence rate were compared. Data was analyzed using STATISTICA (StatSoft,Tulsa,OK) in Window programme. Results: The median operating time was significantly longer in open group (72.4 vs 55 minutes ; p = 0.005 ). The amount of analgesia required in first 5 days was significantly more in open group (108.03 vs 46.92 mg ; p = 0.02). Chest drainage was significantly more in open group ( 1027.14 vs 652.80 ml ; p = 0.04). However, chest drain duration and hospital stay had no significant difference. VATS emerged as cost-effective modality (£ 1770.78 vs £ 3226.05). However, there were 3(5.27%) recurrences in VATS group. Conclusion: We conclude from our experience that VATS pleurectomy is an appropriate modality to treat uncomplicated especially primary spontaneous pneumothorax. However, open pleurectomy is a viable alternative in complicated especially secondary spontaneous pneumothorax.

Page(s): 541-546

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 11, Issue: 9, Year: 2001

Keywords:

Primary spontaneous pneumothorax PSP Secondary spontaneous pneumothorax SSP Parietal pleurectomy Videoassisted thoracoscopic surgery VATS Open posterolateral thoracotomy

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