Cost-effectiveness of video-assisted thoracoscopic surgery versus conservative treatment for first time or recurrent spontaneous pneumothorax

Abstract

C Co os st t--e ef ff fe ec ct ti iv ve en ne es ss s o of f v vi id de eo o--a as ss si is st te ed d t th ho or ra ac co os sc co op pi ic c s su ur rg ge er ry y v ve er rs su us sc co on ns se er rv va at ti iv ve e t tr re ea at tm me en nt t f fo or r f fi ir rs st t t ti im me e o or r r re ec cu ur rr re en nt t s sp po on nt ta an ne eo ou us s p pn ne eu um mo ot th ho or ra ax x Patients in both periods had comparable clinical characteristics. Irrespective of first time or recurrent spontaneous pneumothorax at presentation, drainage and hospitalization times were longer, and complication and recurrence rates were higher in Period 1. When costs due to the waiting time before VATS were excluded, the total costs in Period 1 were higher than in Period 2.Video-assisted thoracoscopic surgery is more effective in treating patients with first time or recurrent spontaneous pneumothorax, with less morbidity and total costs compared to conservative therapy. In view of cost-effectiveness, we feel that a different management of first time or recurrent spontaneous pneumothorax is not justified.

Video-Assisted Thoracoscopic Pleurectomy in Spontaneous Pneumothorax Surgery

“…In our study, the morbidity rate, length of stay with tube, and length of stay in the hospital were consistent with other studies in the literature [6,17,18,22]. Morbidity in the non-pleurectomy group was higher than in the pleurectomy groups.…”

“…In the SSP group, it was detected that all patients had lung lesions. This observation is supported by articles that reported that blebs and bullae were detected in over 80% PSP patients treated with VATS [17][18][19]. In addition, there are some studies that reported that emphysema-like changes were detected by high-resolution CT in 80% of patients with a first episode of PSP [20,21].…”

Additional mechanical pleurodesis after thoracoscopic wedge resection and covering procedure for primary spontaneous pneumothorax

“…There are ongoing debates on how to most effectively lower its recurrence after the first clinical treatment. Conservative treatments, such as needle aspiration or pleural drainage with a chest tube, show rather high recurrence rates, varying from 11% up to 36% [1]. Active surgical operations using thoracoscopy have resulted in a significant reduction in overall morbidity.…”

Spontaneous Pneumothorax Treatment Modalities: A Study of 48 Cases

“…Gözlem, oksijen tedavisi, basit aspirasyon, küçük kateter drenajı, göğüs tüpü drenajı, torakoskopik talk pudraj, VATS ile bleb veya büllektomi, plevral abrazyon veya kısmi plörektomi veya aksiller torakotomi gibi çok farklı yöntemler uygulanabilir. [30][31][32][33][34] Tüm çabalar nüksü önle-mek için plevral yapışıklığı sağlamayı amaçlar. Bunlar arasın-da kimyasal plöredez, plevral abrazyon veya plörektomi yer alır.…”