ArticleInteractive cardiovascular and thoracic surgery2022
Drainless thoracoscopic surgery should be avoided in primary spontaneous pneumothorax with pleural adhesion.
Article in Interactive cardiovascular and thoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 6 citations in OpenAlex.
- The effectiveness and safety of computed tomography-guided hook-wire localization for secondary video-assisted thoracoscopic surgery: a retrospective study.Journal of thoracic disease · 2024Article
- Evaluation of the safety of drainless uniportal video-assisted thoracoscopic surgery for the treatment of primary spontaneous pneumothorax: a two-institution retrospective study.Journal of thoracic disease · 2024Article
- Preoperative risk factors for prolonged length of stay after bullectomy: A single-center retrospective study.Heliyon · 2024Article
- Preliminary outcomes of drainless videothoracoscopic pulmonary wedge resection procedure from Turkey.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2023Article
- Chest tube-free video-assisted thoracoscopic surgery secured by quantitative air leak monitoring: a case series.Journal of thoracic disease · 2023Article
- Editorial: Early chest drain removal following lung resection.Frontiers in surgery · 2023Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDrainless thoracoscopic surgery, defined by omitting chest drain after surgery, has been demonstrated to be feasible in selected patients for pulmonary resection. However, drainless procedure for the treatment of primary spontaneous pneumothorax has raised concerns for its safety and thus has been less often reported. We aimed to share our preliminary experience regarding how to select patients with spontaneous pneumothorax for this procedure.
methodsA retrospective study recruiting 303 consecutive patients with the diagnosis of spontaneous pneumothorax undergoing thoracoscopic surgery in our centre from August 2016 to June 2020 was done. After careful selection, the chest drain was omitted in selected patients who underwent non-intubated uniportal thoracoscopic surgery. Patients' clinical characteristics and perioperative outcomes were analysed.
resultsA total of 34 patients underwent drainless thoracoscopic surgery for the treatment of spontaneous pneumothorax. Pleural adhesion was noted in 9 patients during surgery, and all of them (100%) developed residual pneumothorax, among which intercostal drainage was required in 2 (22.2%) patients and ipsilateral pneumothorax recurred 3 years after surgery in 1 (11.1%) patient. Among the remaining 25 without pleural adhesion, 17 (68.0%) developed minor residual pneumothorax (P = 0.006), which all resolved spontaneously within 1-2 weeks, with no complications or recurrence during postoperative follow-up for at least 2 years.
conclusionsDrainless thoracoscopic surgery for the treatment of primary spontaneous pneumothorax is feasible but can be risky without careful patient selection. In our experience, the drainless procedure should be avoided in patients with identifiable pleural adhesion noted during surgery.
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