Title : Video assisted thoracic surgery outcomes for primary spontaneous
Objective:To evaluate Primary Spontaneous Pneumothorax (PSP) patients who were treated via Video Assisted Thoracic Surgery (VATS) procedure by the means of clinical features, surgical outcomes and follow up results.
Methods: We analysis 56 consecutive patients who underwent VATS procedure for PSP between 2012-2018 retrospectively. There were 47 male and 9 female patients with the mean age of 26,01± 7,4 (18–38) years. VATS was performed under general anesthesia with double lumen intubation. Apical wedge resection and mechanical abrasion or apical pleurectomy performed in 60% of patients with uniportal VATS and two portal VATS in 40% of patients by the same surgical team.
Results: The operation indications were recurrence in 40 (71,5%) patients, prolonged air leak in 14 (25%) and bilateral pneumothorax in 2(3,5%). Pleurodesis procedures included the upper pleural mechanical abrasion in 44 (78,5%) of the patients, apical pleurectomy in 12 (22,5%). Bilateral VATS procedure was performed for two patients who observed bilateral pneumothorax. The mean operation time, chest tube removal time, length of hospital stay was 26.04±4.61 (20–45) minutes, 1,4±0,6 (1-3) days, 1,7 ± 0,8 (2-4) days, respectively. There was no mortality and complications occurred in 16 (28,5 %) patients. Only three (5.3%) recurrence occurred during the 48,4 ± 11,4 months (9 to 70) mean follow-up period.
Conclusion: VATS stapled bullectomy for PSP when followed mechanical pleurodesis is still a gold-standart and is a reliable, safely method with a low recurrence rate, complication, length of hospital stay and quicker recovery time. The formation of new bullae -blebs could be related the continued smoking behavior can be seen as the main reason for late period recurrences.