Research Article
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Year 2021, , 72 - 78, 31.03.2021
https://doi.org/10.7197/cmj.865610

Abstract

References

  • 1. Noppen M, Keukeleire TD. Pneumothorax. Respiration 2008;76:121–127.
  • 2. Li Z, Huang H, Li Q, et al. Pneumothorax: observation. J Thorac Dis 2014;6:S421-S426.
  • 3. Noppen M. Spontaneous pneumothorax: epidemiology, pathophysiology and cause. Eur Respir Rev 2010; 19: 117, 217–219.
  • 4. Huang Y, Huang H, Li Q, et al. Approach of the treatment for pneumothorax. J Thorac Dis 2014;6:S416-S420
  • 5. Kircher LT, Swartzel RL. Spontaneous pneumothorax and its treatment. J Am Med Assoc 1954; 155: 24-9.
  • 6. Henry M, Arnold T, Harvey J. BTS guidelines for the management of spontaneous pnuemothorax. Thorax 2003; 58: ii39-ii52.
  • 7. Işıtmangil T, Balkanlı K. Pnömotoraks ve cerrahi tedavisi. In Yüksel M, Kalaycı G, ed. Göğüs Cerrahisi; Bilmedya Grup, İstanbul, 2001: 411-45.
  • 8. Türkyılmaz A, Erdem AF, Aydın Y, et al. Sekonder spontan pnömotoraksta tedavi: 100 olguluk tecrübe. EAJM 2007;39: 97-102.
  • 9. De Hoyos A, Fry AW. Pneumothorax. In Shields TW, LoCicero III J, Reed CE, Feins RH, ed. General Thoracic Surgery, Vol. 1, 7th ed. Philadelphia: Wolters Cluwer/Lippincott Williams and Wilkins;2009:739-61.
  • 10. Q’Rouke JP, Yee ES. Civilian spontaneous pneumothorax. Treatment options and long-term results. Chest 1989;96:1302-6.
  • 11. Weissberg D, Refaely Y. Pneumothorax: Experience With 1,199 Patients. Chest 2000;117:1279-85.
  • 12. Videm V, Pilligram-Larsen J, Ellingsen O, et al. Spontaneous pneumothorax in chronic obstructive pulmonary disease: complications, treatment and recurrences. Eur J Respir Dis 1987;71:365-71.
  • 13. West JB. Distribution of mechanical stress in the lung, a possible factor in localisation of pulmonary disease. Lancet 1971;1:839-41.
  • 14. Lippert HL, Lund O, Blegvad S, et al. Independent risk factors for cumulative recurrence rate after first spontaneous pneumothorax. Eur Respir J 1991;4:324-31.
  • 15. Güneylioğlu D, Altınsoy B, Çelik O, et al. Pnömotoraks: 174 Olgunun Değerlendirilmesi. Akciğer Arşivi. 2002;2:78-81.
  • 16. Bozkurt AK. Pnömotoraks. Solunum 2002;4: 206-9.
  • 17. Baumann MH, Strange C: Treatment of spontaneous pneumothorax: A more aggresive approach? Chest 1997;112:789-804.
  • 18. Tschopp JM, Rami-Porta R, Noppen M, et al. Management of spontaneous pneumothorax:state of the art. Eur Respir J 2006;28:637-50.
  • 19. Bresticker MA, Oba J, LoCicero J, et al. Optimal pleurodesis: a comparative study. Ann Thorac Surg 1993;55:364-6.
  • 20. Colt HG, Russack V, Chiu Y, et al. A comparison of thoracoscopic talc insufflation, slurry, and mechanical abrasion pleurodesis. Chest 1997;111:442-88.
  • 21. Massard G, Thomas P, Wihlm JM. Minimally invasive management for first and recurrent pneumothorax. Ann Thorac Surg 1998;66:592-9.
  • 22. Schoenenberger RA, Haefeli WE, Weiss P, et al. Timing of invasive procedures in therapy for primary and secondary spontaneous pneumothorax. Arch Surg 1991;126:764-6.
  • 23. Kuzucu A, Soysal Ö, Ulutaş H. Spontan Pnömotoraksta Rekurrens ve Cerrahi Tedavide Zamanlama. Inönü Üni Tıp Fak Der 2005;12:169-72.
  • 24. Freixinet JL, Canalís E, Juliá G, et al. Axillary thoracotomy versus videothoracoscopy for the treatment of primary spontaneous pneumothorax. Ann Thorac Surg 2004;78:417-20.
  • 25. Oğuzkaya F, Kahraman C, Özpolat B, et al. Primer spontan pnömotoraksların tedavisinde video yardımlı torakoskopik cerrahi. GKD Cer Derg 1995;3:263-5.
  • 26. Hayashida R, Hattori R. Postoperative recurrence of pneumothorax after thoracoscopic surgery: a clinical review. Jpn J Chest Dis 1996;55:352-7.
  • 27. Sakurai H, Hada M, Miyashita Y, et al. Simultaneous bilateral spontaneous pneumothorax secondary to metastatic angiosarcoma of the scalp: report of a case. Surg Today 2006;36:919-22.

Approach to patients with secondary spontaneous pneumothorax: Our clinical experience

Year 2021, , 72 - 78, 31.03.2021
https://doi.org/10.7197/cmj.865610

Abstract

Objective: In this study, our aim is to analyze the etiological causes and treatment methods of patients with secondary spontaneous pneumothorax treated in our hospital.
Method: We retrospectively evaluated the data of 152 patients who were treated for Secondary spontaneous pneumothorax between January 2013 - December 2017. All patients diagnosed with SSP were included in the study. The patients were examined in terms of age, gender, current lung disease, smoking, symptoms, imaging findings, localization of pneumothorax, pneumothorax rate, treatment methods, surgical indications, length of hospitalisation and mortality rate.
Results: One hundred and twenty eight (84.2%) of 152 patients were men, 24 were women (15.8%) and their mean age was 66 ± 12.4 (45–98). The most common symptoms were dyspnoea in 114 (75%) patients, chest pain in 85 (55.9%) patients and cough in 26 (17.1%) patients. The most common comorbid pathology was Chronic obstructive pulmonary disease (COPD) in 39.5% patients. Tube thoracostomy was performed in 6 (40%) of 15 (9.9%) patients who were monitored with oxygen therapy. While 112 (73.7%) patients were treated with tube thoracostomy only, 36 (32.1%) of them who were inoperable were treated with pleurodesis by tube thoracostomy. Thirty one (20.4%) patients were treated surgically, of which video-assisted thoracoscopic was performed in 17 (54.8%) and thoracotomy in 14 (45.2%). The majority of our surgical indications were prolonged air leak and recurrent pneumothorax.
Conclusions: Despite the great advances in surgical techniques in thoracic surgery in recent years, a standard treatment protocol has not been established in the treatment of SSP. While pneumothorax can be treated with only chest tube and/or pleurodesis in most patients, morbidity and mortality may increase with surgical treatment. Therefore, surgical treatment should be avoided as much as possible.

References

  • 1. Noppen M, Keukeleire TD. Pneumothorax. Respiration 2008;76:121–127.
  • 2. Li Z, Huang H, Li Q, et al. Pneumothorax: observation. J Thorac Dis 2014;6:S421-S426.
  • 3. Noppen M. Spontaneous pneumothorax: epidemiology, pathophysiology and cause. Eur Respir Rev 2010; 19: 117, 217–219.
  • 4. Huang Y, Huang H, Li Q, et al. Approach of the treatment for pneumothorax. J Thorac Dis 2014;6:S416-S420
  • 5. Kircher LT, Swartzel RL. Spontaneous pneumothorax and its treatment. J Am Med Assoc 1954; 155: 24-9.
  • 6. Henry M, Arnold T, Harvey J. BTS guidelines for the management of spontaneous pnuemothorax. Thorax 2003; 58: ii39-ii52.
  • 7. Işıtmangil T, Balkanlı K. Pnömotoraks ve cerrahi tedavisi. In Yüksel M, Kalaycı G, ed. Göğüs Cerrahisi; Bilmedya Grup, İstanbul, 2001: 411-45.
  • 8. Türkyılmaz A, Erdem AF, Aydın Y, et al. Sekonder spontan pnömotoraksta tedavi: 100 olguluk tecrübe. EAJM 2007;39: 97-102.
  • 9. De Hoyos A, Fry AW. Pneumothorax. In Shields TW, LoCicero III J, Reed CE, Feins RH, ed. General Thoracic Surgery, Vol. 1, 7th ed. Philadelphia: Wolters Cluwer/Lippincott Williams and Wilkins;2009:739-61.
  • 10. Q’Rouke JP, Yee ES. Civilian spontaneous pneumothorax. Treatment options and long-term results. Chest 1989;96:1302-6.
  • 11. Weissberg D, Refaely Y. Pneumothorax: Experience With 1,199 Patients. Chest 2000;117:1279-85.
  • 12. Videm V, Pilligram-Larsen J, Ellingsen O, et al. Spontaneous pneumothorax in chronic obstructive pulmonary disease: complications, treatment and recurrences. Eur J Respir Dis 1987;71:365-71.
  • 13. West JB. Distribution of mechanical stress in the lung, a possible factor in localisation of pulmonary disease. Lancet 1971;1:839-41.
  • 14. Lippert HL, Lund O, Blegvad S, et al. Independent risk factors for cumulative recurrence rate after first spontaneous pneumothorax. Eur Respir J 1991;4:324-31.
  • 15. Güneylioğlu D, Altınsoy B, Çelik O, et al. Pnömotoraks: 174 Olgunun Değerlendirilmesi. Akciğer Arşivi. 2002;2:78-81.
  • 16. Bozkurt AK. Pnömotoraks. Solunum 2002;4: 206-9.
  • 17. Baumann MH, Strange C: Treatment of spontaneous pneumothorax: A more aggresive approach? Chest 1997;112:789-804.
  • 18. Tschopp JM, Rami-Porta R, Noppen M, et al. Management of spontaneous pneumothorax:state of the art. Eur Respir J 2006;28:637-50.
  • 19. Bresticker MA, Oba J, LoCicero J, et al. Optimal pleurodesis: a comparative study. Ann Thorac Surg 1993;55:364-6.
  • 20. Colt HG, Russack V, Chiu Y, et al. A comparison of thoracoscopic talc insufflation, slurry, and mechanical abrasion pleurodesis. Chest 1997;111:442-88.
  • 21. Massard G, Thomas P, Wihlm JM. Minimally invasive management for first and recurrent pneumothorax. Ann Thorac Surg 1998;66:592-9.
  • 22. Schoenenberger RA, Haefeli WE, Weiss P, et al. Timing of invasive procedures in therapy for primary and secondary spontaneous pneumothorax. Arch Surg 1991;126:764-6.
  • 23. Kuzucu A, Soysal Ö, Ulutaş H. Spontan Pnömotoraksta Rekurrens ve Cerrahi Tedavide Zamanlama. Inönü Üni Tıp Fak Der 2005;12:169-72.
  • 24. Freixinet JL, Canalís E, Juliá G, et al. Axillary thoracotomy versus videothoracoscopy for the treatment of primary spontaneous pneumothorax. Ann Thorac Surg 2004;78:417-20.
  • 25. Oğuzkaya F, Kahraman C, Özpolat B, et al. Primer spontan pnömotoraksların tedavisinde video yardımlı torakoskopik cerrahi. GKD Cer Derg 1995;3:263-5.
  • 26. Hayashida R, Hattori R. Postoperative recurrence of pneumothorax after thoracoscopic surgery: a clinical review. Jpn J Chest Dis 1996;55:352-7.
  • 27. Sakurai H, Hada M, Miyashita Y, et al. Simultaneous bilateral spontaneous pneumothorax secondary to metastatic angiosarcoma of the scalp: report of a case. Surg Today 2006;36:919-22.
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Surgical Science Research Articles
Authors

Mehmet Akif Tezcan 0000-0002-2642-187X

İbrahim Ethem Özsoy 0000-0003-2722-5309

Publication Date March 31, 2021
Acceptance Date March 2, 2021
Published in Issue Year 2021

Cite

AMA Tezcan MA, Özsoy İE. Approach to patients with secondary spontaneous pneumothorax: Our clinical experience. CMJ. March 2021;43(1):72-78. doi:10.7197/cmj.865610