Objective: SHP
is an uncommon clinical disorder that is potentially life threatening due to
rapid lung collapse and blodd loss into pleural cavity. . Early surgical
internention for SHP is a life saving procedure, and avoids complications such
as atelectasis, restrictive lung disorders, infection of residual hematoma and
reduce the incidence of delayed surgical exploration and decortication. We
herein report a retrospective study in order to evaluate our demographic
records, intraoperative findings, surgical methods and clinical experience of
early surgery.
Method: We
initially included all patients with primary spontaneous pneumothorax attending
the clinics of Dicle University Faculty of Medicine, Diyarbakir, Turkey and
Cukurova UniversityFaculty of Medicine, Adana, Turkey. From June 2003 and
December 2018, a total of 802 patients were diagnosed as spontaneous
pneumothorax. After thoracocentesis, twenty four of them were diagnosed with
SHP of whom sixteen underwent an prompt thoracotomy or VATS. We retrospectively
collected demographic characteristics, clinical presentations, admitting time
intervals, initial chest tube drainage, surgical strategies, intraoperative
findings and medical history for all SHP patients.
Results: Female / Male ratio was 1/23. Ranging
in age from 16 to 54 years (mean age, 25,6 years). Five patients were underwent
urgent operation because of hypovolemic shock and amount of blood drainage.
Other 11 patients were underwent operation within 24 hours. Ten patients
underwent thoracotomy, and 6 underwent VATS. Remain 8 patients were treated
with tube thoracostomy. During the operations, source of hemorrhage was
detected; apical abberant vessel in 7 patients, torn of parietal pleura in 6
patients and ruptured vascularized bullae/lung parenchyma in 3 patients. No
recurrence of SHP occured with these 24 patients during the follow-up period.
Conclusions:
Early
surgery should be performed in patients who are hemodynamically unstable or
continuous bleeding from pleural drain. Both, VATS and minithoracotomy are
appropriate tecniques for surgery.
Primary Language | English |
---|---|
Subjects | Health Care Administration |
Journal Section | Surgical Science Research Articles |
Authors | |
Publication Date | June 30, 2019 |
Acceptance Date | June 29, 2019 |
Published in Issue | Year 2019 |