MyMedR

Fulltext Video-assisted thoracoscopic surgery for pneumothorax

Lee YM, Lim YC, Liam CK, Aljafri M

Med J Malaysia, 1995 Dec;50(4):334-8.

Five cases of spontaneous pneumothorax were treated with video-assisted thoracoscopic surgery (VATS). These included four cases of recurrent pneumothorax and one case of persistent pneumothorax. The mean age was 33 years. The identified bullae were eliminated with either endoloop ligation (in one patient) or stapled excision (in four patients). There were no recurrences reported in a mean follow-up of 9.4 months. In conclusion, VATS offers an equally effective and less morbid alternative to open thoracotomy in the management of primary spontaneous pneumothorax.

Matched MeSH terms: Pneumothorax/surgery*

Fulltext Single stage minimally invasive bilateral video assisted thoracoscopic surgery for simultaneous bilateral primary spontaneous pneumothorax

Sachithanandan A, Nur Ezrin I, Badmanaban B

Med J Malaysia, 2012 Apr;67(2):226-7.

PMID: 22822653 MyJurnal

Simultaneous bilateral spontaneous pneumothorax (SBSP) is a very rare life-threatening condition that requires rapid diagnosis and treatment. Most cases are secondary to various underlying lung pathology but a primary SBSP may occur due to rupture of subpleural blebs or bullae. Surgery via an open or minimally invasive approach provides definitive treatment and can be undertaken as a staged or simultaneous procedure. We report our experience with two such rare cases utilizing a single stage minimally invasive bilateral video assisted thoracoscopic (VATS) approach. The pathogenesis of this rare condition and intra-operative technical considerations for a successful outcome are discussed.

Matched MeSH terms: Pneumothorax/surgery*

Fulltext Total pleurectomy as the surgical treatment for recurrent secondary spontaneous pneumothorax in a child with severe pulmonary Langerhans cells histiocytosis

Abdul Aziz DA, Abdul Rahman NA, Tang SF, Abdul Latif H, Zaki FM, Annuar ZM, et al.

BMJ Case Rep, 2011;2011.

PMID: 22674944 DOI: 10.1136/bcr.09.2011.4734

Pulmonary Langerhans cell histiocytosis (LCH) in children is more extensive and is a rare cause of spontaneous secondary pneumothorax (SSP) which tends to be recurrent and refractory to conventional treatment. Its occurrence in paediatric patients posed great challenge to the choice of surgical management. Surgery in the form of pleurodesis is only considered if SSP does not improve after chemotherapy and after considering all relevant risk and benefits of surgery to patients. Chemical pleurodesis will not give the expected effect to eradicate SSP in this patient. Therefore mechanical pleurodesis is the treatment of choice. There are various techniques to perform mechanical pleurodesis; from pleural abrasion to pleurectomy. In the authors' experience, bilateral total pleurectomy provided the best outcome for this 9-year-old patient with persistent respiratory distress from SSP due to extensive pulmonary LCH.

Matched MeSH terms: Pneumothorax/surgery*

Primary spontaneous pneumothorax in children: factors predicting recurrence and contralateral occurrence

Ng GYH, Nah SA, Teoh OH, Ong LY

Pediatr Surg Int, 2020 Mar;36(3):383-389.

PMID: 31993738 DOI: 10.1007/s00383-020-04619-x

BACKGROUND: The risk factors for recurrence in primary spontaneous pneumothorax (PSP) in children are not well known. We aimed to identify possible risk factors, and to evaluate the utility of computerised tomography (CT) scans in predicting future episodes.

METHODS: We reviewed children aged pneumothorax laterality, CT results, treatment protocols and recurrences.

RESULTS: 63 patients were included, 19 (30.2%) of whom had CT scans. A total of 41 surgeries were performed. The median (interquartile range) age was 15.4 years (14.9-15.9), and body-mass index was 17.9 kg/m2 (15.8-19.3). 56 (88.9%) patients were male. Median follow-up duration was 19.8 months (11.6-35.9). Multivariate logistic regression analyses identified surgery in the first episode as a predictor for a subsequent contralateral occurrence (odds ratio [95% confidence interval] 32.026 [1.685-608.518], p = 0.021). No predictors for ipsilateral recurrence were found. CT scans were 76.5% sensitive for bleb detection, and predicted poorly for occurrence (positive predictive value 14.3%, likelihood ratio 1.1).

CONCLUSION: This is the first study demonstrating that surgery at first presentation appears to predict for occurrence of PSP on the contralateral lung. CT appears to be ineffective in detecting blebs and predicting PSP occurrence.

Matched MeSH terms: Pneumothorax/surgery*

Pocket-sized Heimlich valve (Pneumostat) after bullae resection: a 5-year review

Abdul Rahman MR, Min Joanna OS, Fikri AM, Adeeb SM, Zamrin DM

Ann Thorac Surg, 2009 Sep;88(3):979-81.

PMID: 19699932 DOI: 10.1016/j.athoracsur.2009.03.065

This study was conducted to evaluate the practicability, effectiveness, and potential complications of a newly improvised pocket-sized Heimlich valve named the Pneumostat (Atrium Medical Corp, Hudson, NH).

Matched MeSH terms: Pneumothorax/surgery*

Pleuroscopic retrieval of a sewing needle from the pleural cavity under conscious sedation by a chest physician

Tie ST, Wong JL, Kannan SK, Rahman JA

J Bronchology Interv Pulmonol, 2012 Jul;19(3):246-8.

PMID: 23207471 DOI: 10.1097/LBR.0b013e31825c3228

We report a case of a young man who presented with a left-sided pneumothorax after suffering an accidental penetrating injury by a sewing needle to the anterior chest wall. Chest radiograph and the computed tomography of the thorax revealed that the needle was in the pleural cavity and there was an associated pneumothorax. An attempt at retrieval by direct incision failed. The sewing needle was successfully retrieved by a medical pleuroscopy. The patient recovered without any consequences and was discharged home after 24 hours of observation.

Matched MeSH terms: Pneumothorax/surgery*

Fulltext Delayed surgical referral for persistent spontaneous pneumothorax : a global problem?

Sachithanandan A, Badmanaban B

Interact Cardiovasc Thorac Surg, 2011 Mar;12(3):434.

PMID: 21345828 DOI: 10.1510/icvts.2010.241950A

Matched MeSH terms: Pneumothorax/surgery*

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