Transaxillary Pleurectomy for Treatment of Spontaneous Pneumothorax

Deslauriers, Jean; Beaulieu, M; Després, Jean-Paul; Lemieux, Michel; LeBlanc, Jacques G.; Desmeules, Marc

doi:10.1016/s0003-4975(10)61733-x

Cited by 120 publications

(30 citation statements)

References 32 publications

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“…The average number of pneumothoraces per patient before pleural abrasion was [3][4][5] (range 1-15). Eleven procedures were performed in patients with an unresolved pneumothorax; 19 procedures were performed in patients with an acute recurrence and 13 were performed electively.…”

Section: Resultsmentioning

confidence: 99%

Pleural abrasion via axillary thoracotomy in the era of video assisted thoracic surgery.

Simansky

Yellin

1994

Thorax

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Background-Recurrent episodes ofspontaneous pneumothorax can be managed medically or surgically by various methods, video assisted thoracoscopy being the latest and most attractive. Methods-A retrospective analysis was made of 43 pleural abrasions performed in 39 patients through a 4-6 cm axillary thoracotomy incision. Results-There were no deaths and complications were few. At a mean follow up of 33 months there were two recurrences, neither of which required drainage. Conclusions-Compared with results achieved with video assisted thoracoscopic surgery, open pleural abrasion via a small thoracotomy may be the treatment of choice in most hospitals.

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Section: Resultsmentioning

confidence: 99%

Pleural abrasion via axillary thoracotomy in the era of video assisted thoracic surgery.

Simansky

Yellin

1994

Thorax

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“…4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] However, concerning long-term sequelae in terms of workaday restrictions caused by pain and anxiety attributed to surgery, the presented data have to be interpreted with caution. Especially in the light of (i) strong interindividual estimation differences as to the degree of impairment and (ii) the VATS technique applied at the investigated timeframe (three-port approach), a somewhat higher percentage (45% of VATS patients) can be anticipated.…”

Section: Discussionmentioning

confidence: 99%

Recurrence of Spontaneous Pneumothorax Is Not Associated with Allegedly Risk-Prone Lifestyle Conduct

Steger

Sostheim

Leistner

et al. 2018

ATCS

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Purpose: Spontaneous pneumothorax (PNTX) is a common disease frequently operated at specialized thoracic surgery units. Videothoracoscopic surgery (VATS) has become the standard for treatment and recurrence prevention. While there is broad consensus regarding indications and techniques of PNTX surgery, postoperative risks and consecutive patient behavioral advice have not been sufficiently elucidated. Methods: Single-center cohort analysis of 641 patients operated for primary PNTX by VATS over 10 years. Putatively recurrence-prone lifestyle activities (smoking status, flying habits, and scuba diving) and actual occurrence of recurrences were correlated. Results: Follow-up rate was 46% (279/607 patients). Mean time interval between primary operation and follow-up was 61 (range: 5-177) months. In 10 patients (3.6%), a PNTX recurrence was observed. Regarding postoperative risk behavior reported at follow-up, 28% of patients were active smokers (15 ± 7 cigarettes/day), 59% traveled by plane repeatedly, and only two patients did scuba diving (0.7%). Low body-mass-index was associated with an increase in PNTX recurrence, whereas smoking, flying, and scuba diving could not be identified as risk factors. Conclusion: In our study, none of the supposed "classic" lifestyle-associated risk factors for PNTX recurrence after VATS proved to be a significant threat. Postoperative patient behavior might not be constrained by overcautious medical advice.

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“…Axillar thoracotomy has excellent results with respect to relapse and morbidity, and our groups used it until the introduction of VATS [2]. The rate of relapse with axillar thoracotomy in the treatment of PSP is 1%, a figure outlined in a classic study by DESLAURIERS et al [6], and there are still groups that consider axillar thoracotomy as the treatment of choice for PSP [7]. As an alternative approach, posterolateral thoracotomy has also been reported, but it is more often used in the treatment of secondary spontaneous pneumothorax (SSP) [8].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of primary spontaneous pneumothorax with video-assisted thoracic surgery

Freixinet¹,

Canalís²,

Rivas³

et al. 1997

Eur Respir J

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We report the results of our experience using video-assisted thoracoscopic surgery (VATS) to treat primary spontaneous pneumothorax (PSP) from January 1992 until December 1994 in a multicentered co-operative study.A total of 132 patients (110 males and 22 females, aged 13-38 yrs, mean age 26 yrs) were treated by VATS to deal with the PSP that they presented with. A standard VATS technique was used. Apical bullae were always removed, and mechanical pleural abrasion was performed, leaving a pleural drainage tube.In two cases (1.5%), a switch to thoracotomy was necessary. In eight cases (6%), air leakage persisted for 5 days after surgery, which resolved with pleural drainage. There were eight postoperative relapses (6%), which were treated with pleural drainage (n=4), VATS (n=3) or axillar thoracotomy (n=1). The average postoperative stay was 5.6 days (range 2-15 days).We conclude that video-assisted thoracoscopic surgery is a viable alternative for the treatment of primary spontaneous pneumothorax. There is, however, a high relapse rate, and in a number of cases air leakage persists in the postoperative period. Eur Respir J 1997; 10: 409-411 Primary spontaneous pneumothorax (PSP) is a benign process, but persistent air leaks or recurrence make surgical intervention necessary in 30-40% of cases. PSP has come to be treated in the classic form, through axillar thoracotomy; the results published have been good, with a minimum rate of relapse and morbidity [1][2][3][4]. Recent developments in video-assisted thoracoscopic surgery (VATS) allowed a change in surgical technique, reducing surgical intervention. In order to evaluate VATS technique in PSP we initiated a multicentered study covering a period of 3 yrs. Materials and methodsBetween January 1992 and December 1994, a co-operative multicentered study was carried out by the Thoracic Surgery departments of three teaching hospitals. A total of 132 patients affected with PSP were treated by VATS. The indications for surgery for PSP were as follows: 1) persistent air leakage of more than 7 days after pleural drainage at the first episode of PSP (n=24); and 2) ipsilateral relapse in a case of PSP previously treated by pleural drainage (n=108). Cases of spontaneous pneumothorax, in which the patient had no primary pulmonary disease, were considered to have PSP.Patients treated through axillar thoracotomy during this same period of time were excluded from the study, as were patients with secondary pneumothorax, those more than 40 yrs of age (although not suspected of having basic pulmonary disease), and those of traumatic origin.The technique used was the same in all cases. It was carried out using general anaesthesia with a doublelumen endobronchial tube. Three incisions were made in order to introduce the optical equipment, the thoracic endoscopy instruments, and the endosutures. A removal of (generally apical) bullae or dystrophic complexes responsible for the episodes of pneumothorax was always performed. In cases of air leakage, air leak tests were performe...

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Transaxillary Pleurectomy for Treatment of Spontaneous Pneumothorax

Cited by 120 publications

References 32 publications

Pleural abrasion via axillary thoracotomy in the era of video assisted thoracic surgery.

Pleural abrasion via axillary thoracotomy in the era of video assisted thoracic surgery.

Recurrence of Spontaneous Pneumothorax Is Not Associated with Allegedly Risk-Prone Lifestyle Conduct

Surgical treatment of primary spontaneous pneumothorax with video-assisted thoracic surgery

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