Miniinvasive Surgery in Spontaneous Pneumothorax – Indications and Surgical Technique


Authors: J. Vodička;  V. Špidlen
Authors‘ workplace: Chirurgická klinika Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Plzni přednosta prof. MUDr. V. Třeška, DrSc.
Published in: Rozhl. Chir., 2008, roč. 87, č. 6, s. 284-290.
Category: Monothematic special - Original

Overview

The aim of the spontaneous pneumothorax management is to recover permanent inflation of the affected lung to its original extent, and to prevent air leaks. The outcomes of miniinvasive surgeries, including videothoracoscopy and videoassissted procedures, are similar to those in classical procedures, while traumatization of the tissue and the patient’s stress are minimized. The study gathered information from a number of literature data and provides an up-to- date overview of the subject of the spontaneous pneumothorax miniinvasive surgery, and, in particular, a detail analysis of particular indications, contraindications, surgical techniques and the technique’s prospects. Currently, videothoracoscopy is considered a method of the first choice in the spontaneous pneumothorax relapses, and, in specific indications it is also accepted to manage the first attack of the disorder. A combination of the lung and pleural procedures is considered the most reliable. Peripheral lung resection using endostaplers appears the most suitable lung management method. Considering pleurodesis procedures, mechanical methods show superior results, the optimum procedure being partial apical pleurectomy in combination with pleuroabrasion in the remaining pleural cavity.

Key words:
spontaneous pneumotorax – videothoracoscopy – indications – contraindications – surgical procedrue


Sources

1. Gómez-Caro, A., Moradiellos, F. J., Larrú, E., et al. Effectiveness and complications of video-assisted surgery for primary spontaneous pneumothorax. Arch. Bronconeumol., 2006; 42: 57–61.

2. van Schil, P., Hendriks, J., de Maeseneer, M., et al. Current management of spontaneous pneumothorax. Monaldi Arch. Chest Dis., 2005; 63: 204–212.

3. Balduyck, B., Hendriks, J., Lauwers, P., et al. Quality of life evolution after surgery for primary or secondary spontaneous pneumothorax: a prospective study comparing different surgical techniques. Interact Cardiovasc Thorac Surg., 2008; 7: 45–49.

4. Bobbio, A., Ampollini, L., Internullo, E., et al. Thoracoscopic parietal pleural argon beam coagulation versus pleural abrasion in the treatment of primary spontaneous pneumothorax. Eur. J. Cardiothorac. Surg., 2006; 29: 6–8.

5. Cardillo, G., Carleo, F., Giunti, R., et al. Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: a single-institution experience in 861 cases. J. Thorac. Cardiovasc. Surg., 2006; 131: 322–328.

6. Fernandez, M. I., Martin-Ucar, A. E., Lee, H. D., et al. Does a thoracic epidural confer any additional benefit following video-assisted thoracoscopic pleurectomy for primary spontaneous pneumothorax? Eur. J. Cardiothorac. Surg., 2005; 27: 671–674.

7. Klopp, M., Dienemann, H., Hoffmann, H. Treatment of pneumothorax. Chirurg, 2007; 78: 655–668.

8. Santillán-Doherty, P., Argote-Greene, L.M., Guzman-Sanchez, M. Thoracoscopic management of primary spontaneous pneumothorax. Am Surg., 2006; 72: 145–149.

9. Tschopp, J. M., Frank, W., Noppen, M. The management of spontaneous pneumothorax. Pneumologie, 2005; 59: 879–889.

10. Cardillo, G., Facciolo, F., Regal, M., et al. Recurrences following videothoracoscopic treatment of primary spontaneous pneumo- thorax: the role of redo-videothoracoscopy. Eur. J. Cardiothorac. Surg., 2001; 19: 396–399.

11. Doddoli, C., Barlesi, F., Fraticelli, A., et al. Video-assisted thoracoscopic management of recurrent primary spontaneous pneumothorax after prior talc pleurodesis: a feasible, safe and efficient treatment option. Eur. J. Cardiothorac. Surg., 2004; 26: 889–892.

12. Lang-Lazdunski, L., de Kerangal, X., Pons, F., et al. Primary spontaneous pneumothorax: one-stage treatment by bilateral videothoracoscopy. Ann. Thorac. Surg., 2000; 70: 412–417.

13. Watanabe, S., Sakasegawa, K., Kariatsumari, K., et al. Bilateral video-assisted thoracoscopic surgery in the supine position for primary spontaneous pneumothorax. Thorac. Cardiovasc. Surg., 2004; 52: 42–44.

14. Ayed, A. K. Bilateral video-assisted thoracoscopic surgery for bilateral spontaneous pneumothorax. Chest, 2002; 122: 2234–2237.

15. Maruyama, R., Anai, H. Video-assisted thoracoscopic surgery for bilateral spontaneous pneumothorax in supine position: the use of a pillow beneath the back for intercostal space widening. Thorac. Cardiovasc. Surg., 2000; 48: 370–371.

16. Wu, Y. C., Chu, Y., Liu, Y. H., et al. Thoracoscopic ipsilateral approach to contralateral bullous lesion in patients with bilateral spontaneous pneumothorax. Ann. Thorac. Surg., 2003; 76: 1665–1667.

17. Türüt, H., Gulhan, E., Gezer, S., et al. Diffuse Cystic Disease of the Lung Associated with Simultaneous Bilateral Spontaneous Pneumothorax: An Unknown Component of Caroli Disease? Respiration, 2006; [Epub ahead of print].

18. Rivo Vazquez, J. E., Canizares Carretero, M. A., Garcia Fontan, E., et al. Surgical treatment of recurrent spontaneous pneumothorax: what is the optimal timing? Arch Bronconeumol., 2004; 40: 275–278.

19. Pearson, F. G., Cooper, J. D., Deslauriers, J., et al. Thoracic Surgery. Second Edition. Philadelphia, Churchill Livingstone, 2002.

20. Kakaris, S., Athanassiadi, K., Vassilikos, K., et al. Spontaneous hemopneumothorax: a rare but life-threatening entity. Eur. J. Cardiothorac. Surg., 2004; 25: 856–858.

21. Issaivanan, M., Baranwal, P., Abrol, S., et al. Spontaneous hemopneumothorax in children: case report and review of literature. Pediatrics, 2006; 118: 1268–1270.

22. Luh, S. P., Tsao, T. C. Video-assisted thoracic surgery for spontaneous haemopneumothorax. Respirology, 2007; 12: 443–447.

23. Chang, Y. T., Dai, Z. K., Kao, E. L., et al. Early video-assisted thoracic surgery for primary spontaneous hemopneumothorax. World J. Surg., 2007; 31: 19–25.

24. Hsiao, C. W., Lee, S. C., Tzao, C., et al. Minithoracotomy with simultaneous video-assisted thoracoscopic surgery vs. video-assisted thoracoscopic surgery for spontaneous hemopneumothorax. Thorac. Cardiovasc. Surg., 2003; 51: 288–290.

25. Hirai, S., Hamanaka, Y., Mitsui, N., et al. Therapeutic strategy for spontaneous pneumothorax. Kyobu Geka, 2007; 60: 175–179.

26. Ouanes-Besbes, L., Golli, M., Knani, J., et al. Prediction of recurrent spontaneous pneumothorax: CT scan findings versus management features. Respir. Med., 2007; 101: 230–236.

27. Choudhary, A. K., Sellars, M. E., Wallis, C., et al. Primary spontaneous pneumothorax in children: the role of CT in guiding management. Clin. Radiol., 2005; 60: 508–511.

28. Sihoe, A. D., Au, S. S., Cheung, M. L., et al. Incidence of chest wall paresthesia after video-assisted thoracic surgery for primary spontaneous pneumothorax. Eur. J. Cardiothorac. Surg., 2004; 25: 1054–1058.

29. Lee, C. C., Lee, S. H., Chang, I. J., et al. Spontaneous pneumothorax associated with ankylosing spondylitis. Rheumatology, 2005; 44: 1538–1541.

30. Čapov, I., Wechsler, J., Jedlička, V., et al. Je videotorakoskopie indikována u první epizody spontánního pneumotoraxu? Bratisl. Lek. Listy, 1997; 98: 500–502.

31. Schützner, J., Pafko, P. Prvních 300 videotorakoskopických (VTS) a videoasistovaných (VATS) operací. Rozhl. Chir., 1996; 75: 255–259.

32. Pafko, P., a kol. Praktická laparoskopická a torakoskopická chirurgie. Praha, Grada Publishing, 1998.

33. Čapov, I. Videoasistovaná torakoskopie a její význam v léčbě spontánního pneumotoraxu. Habilitační práce. Brno, Masarykova univerzita, 1998.

34. Chang, Y. C., Chen, C. W., Huang, S. H., et al. Modified needlescopic video-assisted thoracic surgery for primary spontaneous pneumothorax: the long-term effects of apical pleurectomy versus pleural abrasion. Surg. Endosc., 2006; 20: 757–762.

35. Jutley, R. S., Khalil, M. W., Rocco, G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur. J. Cardiothorac. Surg., 2005; 28: 43–46.

36. Cho, K. D., Park, C. B., Cho, M. S., et al. Modification of Thoracoscopic Surgery for Spontaneous Pneumothorax. Asian Cardiovasc. Thorac. Ann., 2006; 14: 472–475.

37. Luh, S. P., Tsai, T. P., Chou, M. C., et al. Video-assisted thoracic surgery for spontaneous pneumothorax: outcome of 189 cases. Int. Surg., 2004; 89: 185–189.

38. Ayed, A. K., Chandrasekaran, C., Sukumar, M. Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: clinicopathological correlation. Eur. J. Cardiothorac. Surg., 2006; 29: 221–225.

39. Ogawa, E., Takenaka, K., Kawashita, F., et al. Prevention of overlooked bullae during video-assisted thoracic surgery (VATS) with a combination of high frequency jet ventilation (HFJV) and positive end-expiratory pressure (PEEP) for spontaneous pneumothorax. Thorac. Cardiovasc. Surg., 2005; 53: 56–60.

40. Noppen, M., Dekeukeleire, T., Hanon, S., et al. Fluorescein-enhanced Autofluorescence Thoracoscopy in Patients with Primary Spontaneous Pneumothorax and Normal Subjects. Am. J. Respir. Crit. Care Med., 2006; 174: 26–30.

41. Hatz, R. A., Kaps, M. F., Meimarakis, G., et al. Long-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax. Ann. Thorac. Surg., 2000; 70: 253–257.

42. Horio, H., Nomori, H., Kobayashi, R., et al. Impact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax. Surg. Endosc., 2002; 16: 630–634.

43. Zeman M., et al. Speciální chirurgie. Praha, Galén, 2001.

44. Čapov, I., Wechsler, J., Jedlička, V., Peštál, A. Prevence vzduchové netěsnosti při videotorakoskopické resekci emfyzematózní plíce. Min. Ter., 1998; 3: 172–174.

45. Rindoš, R., Hamžík, J., Láska, M., et al. Spontánny pneumotorax – súčasný pohlad na liečbu. Rozhl. Chir., 1994; 73: 335–338.

46. Galbis Caravajal, J. M., Mafe Madueno, J. J., Benlloch Carrion, S., et al. Video-assisted thoracoscopic surgery in the treatment of pneumothorax: 107 consecutive procedures. Arch. Bronconeumol., 2003; 39: 310–313.

47. Lang-Lazdunski, L., Chapuis, O., Bonnet, P. M., et al. Video-thoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term results. Ann. Thorac. Surg., 2003; 75: 960–965.

48. Maier, A., Anegg, U., Renner, H., et al. Four-year experience with pleural abrasion using a rotating brush during video-assisted thoracoscopy. Surg. Endosc., 2000; 14: 75–78.

49. Kruger, M., Ermitsch, M., Uschinsky, K., et al. Results of video-assisted thoracoscopic surgery for pneumothorax. Zentralbl. Chir., 2003; 128: 645–651.

50. Naunheim, K. S., Mack, M. J., Hazelrigg, S. R., et al. Safety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax. J. Thorac. Cardiovasc. Surg., 1995; 109: 1198–1204.

Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account