SURGICAL TACTICS IN SPONTANEOUS PNEUMOTHORAX
Keywords:
Spontaneous pneumothorax, videothoracoscopy, pleurodesisAbstract
Purpose of the study. Improving the results of treatment of spontaneous pneumothorax.
Material and methods. We have analyzed the results of treatment of 102 patients with spontaneous pneumothorax.
In 68 (66.6%) patients spontaneous pneumothorax was caused by bullous emphysema, in 10 (9.8%) patients there was a rupture of the postpneumonic cyst of the lungs, in 7 (6.9%) patients the rupture of an echinococcal cyst into the pleural cavity and in 17 (16.7%) %) pneumothorax developed due to unclear circumstances.
In our patients, a history of a single recurrence was noted in 10 (9.8%) patients, a two-time relapse in 8 (7.8%) and a three-time relapse in 5 (4.9%) patients. Complicated pneumothorax in the form of hydropneumothorax was noted in 17 (16.7%) patients.
Results. Pleural puncture was performed in 12 patients with apical pneumothorax and 5 patients with middle pneumothorax. The remaining 12 patients with middle pneumothorax underwent active drainage of the pleural cavity.
Videothoracoscopic (VTS) surgeries were performed in 58 (56.9%) patients with spontaneous pneumothorax. 7 patients underwent video-assisted thoracoscopic surgery. And only 8 cases were performed through wide thoracotomy accesses.
Video-assisted atypical lung resection and pleurectomy were performed in 8 (13.8%) cases, using a UO-40 stapler through a minithoracotomy access.
Postoperative complications were noted in the group (n = 8) who underwent surgery through thoracotomy access: 1 (12.5%) patient had a residual pleural cavity and 1 (12.5%) had pleurisy. Recurrent spontaneous pneumothorax occurred in 5 (17.2%) patients treated with aspiration and drainage procedures (n = 29).
Conclusions. It has been established that video-assisted and video-assisted operations through mini-access with the elimination of the cause of spontaneous pneumothorax and mandatory pleurodesis is the operation of choice. Aspiration and drainage procedures for spontaneous pneumothorax remain the main preliminary tactical treatment.
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