Parietal pleurectomy for recurrent pneumothorax

Askew, A. R.

doi:10.1002/bjs.1800630309

Cited by 35 publications

(8 citation statements)

References 11 publications

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“…This procedure may be associated with a considerable amount of pain and an unacceptably high recurrence rate (9, and Gaensler (6) reported much better results, with the operation of parietal pleurectomy. There have been two recent reports in which parietal pleurectomy was considered an important feature of the surgical management of spontaneous pneumothorax (7,8).…”

Section: Discussionmentioning

confidence: 99%

Excision of bullae without pleurectomy in patients with spontaneous pneumothorax

Ferguson

Imrie

Hutchison

1981

Journal of British Surgery

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In a retrospective review of 294 patients with spontaneous pneumothorax (398 episodes), 45 patients came to surgical treatment. The period of the study was 7 1/2 years, with a mean follow-up of 3 years in which there was no recurrence of pneumothorax after surgery. Operation consisted of simple excision of bullous lesions, usually located at the apex of the upper lobe, without pleurectomy. This simplified surgical approach has met with excellent result, indicating that pleurectomy is unnecessary in the treatment of this disease.

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Section: Discussionmentioning

confidence: 99%

Excision of bullae without pleurectomy in patients with spontaneous pneumothorax

Ferguson

Imrie

Hutchison

1981

Journal of British Surgery

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“…Pleurectomy was used to treat recurrent spontaneous pneumothorax for the first time in 1956, in nine patients [74]. In the following years, partial pleurectomy or pleural abrasion became standard therapy, especially for recurrent spontaneous pneumothorax, and resulted in average recurrence rates of 1% [9,[75][76][77]. Combined pleurectomy and bullectomy showed average recurrence rates of 2% [7,13,14,17,78,79].…”

Section: Surgical Therapymentioning

confidence: 99%

“…Reviewing the results of VATS in 805 patients with spontaneous pneumothorax, the mean recurrence rate was 4% (table 4) [10][11][12][80][81][82][83][84][85][86][87][88][89][90][91], which was higher than the mean recurrence rate of 1.5% after conventional surgical therapy (table 3) [7,9,13,14,17,[74][75][76][77][78]. However, several studies that have reported comparative analysis of VATS versus conventional thoracotomy have shown reduced operation time, drainage time and complication rates after VATS, resulting in shorter hospital stay and a more rapid return to the normal daily activities of the patients [84,92,93].…”

Section: Surgical Therapymentioning

confidence: 99%

Current aspects of spontaneous pneumothorax

Schramel¹,

Postmus²,

1997

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In spite of the fact that blebs and bullae are frequently found in patients with primary spontaneous pneumothorax, they seldom seem to be the actual cause of the pneumothorax. Inflammatory changes in the distal airways play an important role in the occurrence of the pneumothorax during transpulmonary pressure changes.The value of the routine use of additional expiratory chest radiographs in diagnosing pneumothoraces has been doubted in previous studies. In this review, the diagnostic yield from additional expiratory chest radiographs is analysed. The role of previous pneumothoraces at presentation and the presence of blebs and bullae are discussed in predicting future recurrences and choosing appropriate treatment for optimal cost-effectiveness. Recommendations are made regarding treatment of primary and secondary spontaneous pneumothorax. Eur Respir J 1997; 10: 1372-1379 Pneumothorax is defined as the presence of air in the pleural cavity [1]. As early as 1819, LAENNEC [2] described the symptoms and signs of a patient with a pneumothorax. Although most pneumothoraces were then caused by tuberculosis, he also found pneumothoraces during autopsies of patients with apparently healthy lungs; he named these "pneumothorax simple". Aetiology and pathogenesisToday, pneumothoraces are divided into spontaneous pneumothorax, occurring without a preceding event, and traumatic pneumothorax, due to direct or indirect trauma. Iatrogenic pneumothoraces, resulting from diagnostic or therapeutic medical procedures, are also categorized as traumatic pneumothoraces.Spontaneous pneumothoraces are divided into primary and secondary spontaneous pneumothoraces. Secondary spontaneous pneumothoraces are associated with underlying pulmonary pathology, usually chronic obstructive pulmonary disease (COPD). Acquired immune deficiency syndrome (AIDS) and Pneumocystis carinii infections appear to play an increasing role in the aetiology of secondary spontaneous pneumothoraces [3].No underlying pulmonary disease is present in patients with primary spontaneous pneumothorax. However, blebs and bullae seem to play a role in the pathogenesis, since they are frequently found during thoracoscopy, thoracotomy or sternotomy (table 1). Thoracoscopic studies have shown the presence of blebs and bullae in 48-79% of patients with unilateral primary spontaneous pneumo-thorax [4][5][6][7][8]. With the development of video-assisted techniques, the recognition of blebs and bullae during thoracoscopy has improved. In more than 76% of patients,

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“…Die alleinige intrathorakale Drainage hat mit 20-30% im Mittel zwar die höchste Rezidivrate, ist aber zumindest in chirurgischen Einrichtungen, die nicht mit der Videothorakoskopie vertraut sind, Standard beim Erstereignis [2,22]. Die alleinige intrathorakale Drainage hat mit 20-30% im Mittel zwar die höchste Rezidivrate, ist aber zumindest in chirurgischen Einrichtungen, die nicht mit der Videothorakoskopie vertraut sind, Standard beim Erstereignis [2,22].…”

Section: Diskussionunclassified

“…Die jährliche Inzidenz wird mit 7-28 Neuerkrankungen pro 100.000 und Jahr angegeben [1,8], das Geschlechtsverhältnis zwischen Männern und Frauen beträgt 4-5:1 [2,10]. 70-80% der Patienten klinisch ohne Rezidiv [1,2,22]. 70-80% der Patienten klinisch ohne Rezidiv [1,2,22].…”

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