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Transaxillary mini thoracotomy as an alternative to thoracoscopy in the treatment of primary spontaneous pneumothorax: A prospective cohort study

Yıl 2020, , 293 - 295, 01.04.2020
https://doi.org/10.28982/josam.655089

Öz

Aim: Arguments comparing the outcomes of traditional open surgery and endoscopic approach performed for the treatment of primary spontaneous pneumothorax persist. This study aims to reveal the efficiency of transaxillary mini thoracotomy which is considered an alternative to thoracoscopy.
Methods: This study was conducted with 40 patients who underwent 3-port thoracoscopy and 40 patients who were treated with transaxillary mini thoracotomy for pneumothorax between 2012 and 2018. Two different types of surgery were compared in terms of age, gender, side of operation, duration of hospital stay, complications, recurrence and total cost.
Results: The whole group included 68 (85%) males and 12 (15%) females. Mean age was 25 (3.96) (range: 18-35) years. Pneumothorax was right sided in 42 (52.5%) patients. Mean hospital stay was 2.86 (0.56) (range: 2-4) days. Average cost was 3263.75 (563.71) TL per patient. Complications occurred in 11 (13.75%) patients whereas 4 (5%) cases developed recurrence. Groups of different surgeries had no statistically significant difference in terms of age, gender, side of operation, duration of hospital stay, rates of complication and recurrence while the average of cost was significantly lower for thoracotomy group.
Conclusion: Regarding the identical surgical outcomes and lower cost, transaxillary mini thoracotomy can be safely preferred as an alternative to thoracoscopy for the treatment of spontaneous pneumothorax.

Kaynakça

  • 1. Paliouras D, Barbetakis N, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, et al. Video-assisted thoracic surgery and pneumothorax. J Thorac Dis.2015;7(1):56-61.
  • 2. Park KT. The usefulness of two-port video-assisted thoracosopic surgery in low-risk patients with secondary spontaneous pneumothorax compared with open thoracotomy. Ann Thorac Med 2014;9:29-32.
  • 3. Yim AP, Ng CS. Thoracoscopy in the management of pneumothorax. Curr Opin Pulm Med. 2001;7:210-4.
  • 4. Nikolouzos S, Kanakis M, Zacharia G, Gatsoulis N, Dritsas I, Papagiannakis G, et al. VATS in the treatment of primary spontaneous pneumothorax:present, past and future. Hel J Surg. 2013;85(1):8-17.
  • 5. Hatz RA, Kaps MF, Meimarakis G, Loehe F, Muller C, Furst H. Long-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax. Ann Thorac Surg 2000;70:253–7.
  • 6. Sihoe ADL, Yu PSY, Yeung JWL. Primary pneumothorax: Should surgery be offered after the first episode? World J Respirol 2015;5(1):47-57.
  • 7. Joshi V, B Kirmani, J Zacharias. Thoracotomy versus VATS: is there an optimal approach to treating pneumothorax? Ann R Coll Surg Engl. 2013;95:61–4.
  • 8. Bagheri R, Haghi SZ, Attaran D, Ebadi F, Rajabnejad Y, Rajabnejad A. Video-assisted thoracoscopic surgery versus axillary thoracotomy in primary spontaneous pneumothorax. J Cardiothor Med. 2017;5(1):538-42.
  • 9. Ng CSH, Lee TW, Wan S, Yim APC. Video assisted thoracic surgery in the management of spontaneous pneumothorax: the current status. Postgrad Med J. 2006;82:179–85.
  • 10. Gossot D, Galetta D, Stern JB, Debrosse D, Caliandro R, Girard P, et al. Results of thoracoscopic pleural abrasion for primary spontaneous pneumothorax. Surg Endosc 2004;18:466–71.
  • 11. Chen JS, Hsu HH, Kuo SW, Tsai PR, Chen RJ, Lee JM, et al. Effects of additional minocycline pleurodesis after thoracoscopic procedures for primary spontaneous pneumothorax. Chest. 2004;125:50–5.
  • 12. Doddoli C, Barlesi F, Fraticelli A, Thomas P, Astoul P, Giudicelli R, 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;26:889–92.
  • 13. Van Schil P. Cost analysis of video-assisted thoracic surgery versus thoracotomy: critical review. Eur Respir J. 2003; 22:735–8.
  • 14. Kim KH, Kim HK, Han JY, Kim JT, Wen YS, Choi SS. Transaxillary minithoracotomy versus video-assisted thoracic surgery for spontaneous pneumothorax. Ann Thorac Surg. 1996;61:1510–12.
  • 15. Pages PB, Delpy JP, Falcoz PE, Thomas PA, Filaire M, Le Pimpec BF, et al. Videothoracoscopy versus thoracotomy for the treatment of spontaneous pneumothorax: a propensity score analysis. Ann Thorac Surg. 2015;99:258–64.
  • 16. Hamada A, Oizumi H, Kato H, Suzuki J, Nakahashi K, Sho R, et al. Learning curve for port-access thoracoscopic anatomic lung segmentectomy. J Thorac Cardiovasc Surg. 2019;156(5):1995-2003.
  • 17. Cao C, Petersen RH, Yan TD. Learning curve for video-assisted thoracoscopic lobectomy. J Thorac Cardivasc Surg. 2014;147(5):1727.
  • 18. Chang CC, Yen YT, Lin CY, Chen YY, Huang WL, Tseng YL. Single-port video-assisted thoracoscopic surgery subsegmentectomy: The learning curve and initial outcome. Asian J Surg. 2020;43:625-32.

Primer spontan pnömotoraks tedavisinde torakoskopinin alternatifi olarak transaksiller mini torakotomi: Prospektif kohort çalışma

Yıl 2020, , 293 - 295, 01.04.2020
https://doi.org/10.28982/josam.655089

Öz

Amaç: Primer spontan pnömotoraks tedavisinde uygulanan geleneksel açık cerrahi ve endoskopik yaklaşımların sonuçları karşılaştırılmaya devam etmektedir. Bu çalışma torakoskopinin alternatifi olarak kabul edilen transaksiller mini torakotominin etkinliğini belirlemeyi hedeflemektedir.
Yöntemler: 2012 ile 2018 tarihleri arasında pnömotoraks nedeniyle 3-port torakoskopi ve transaksiller mini torakotomi uygulanmış olan 40’ar hastayı içeren bir çalışma yürütüldü. İki farklı cerrahi tipi yaş, cinsiyet, ameliyat tarafı, hastanede kalış süresi, komplikasyonlar, nüks ve toplam maliyet açısından karşılaştırıldı.
Bulgular: Tüm grupta 68 (%85) erkek ve 12 (%15) kadın hasta vardı. Ortalama yaş 25 (3,96) (aralık: 18-35) yıl idi. Pnömotoraks 42 (%52.5) hastada sağ tarafta saptandı. Ortalama hastanede kalış süresi 2,86 (0,56) (aralık: 2-4) gün olarak hesaplandı. Hasta başına ortalama 3263,75 (563,71) TL masraf yapıldı. Toplam 11 (%13,75) hastada komplikasyon gelişirken 4 (%5) hastada nüks saptandı. Farklı cerrahi yapılan grupları arasında yaş, cinsiyet, ameliyat tarafı, hastanede kalış süresi ile komplikasyon ve nüks oranları açısından istatistiksel olarak anlamlı fark yokken maliyet torakotomi grubunda belirgin olarak düşüktü.
Sonuç: Spontan pnömotoraks tedavisinde benzer cerrahi sonuçları ve daha düşük maliyeti göz önüne alındığında transaksiller mini torakotomi torakoskopiye alternatif olarak güvenle tercih edilebilir.

Kaynakça

  • 1. Paliouras D, Barbetakis N, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, et al. Video-assisted thoracic surgery and pneumothorax. J Thorac Dis.2015;7(1):56-61.
  • 2. Park KT. The usefulness of two-port video-assisted thoracosopic surgery in low-risk patients with secondary spontaneous pneumothorax compared with open thoracotomy. Ann Thorac Med 2014;9:29-32.
  • 3. Yim AP, Ng CS. Thoracoscopy in the management of pneumothorax. Curr Opin Pulm Med. 2001;7:210-4.
  • 4. Nikolouzos S, Kanakis M, Zacharia G, Gatsoulis N, Dritsas I, Papagiannakis G, et al. VATS in the treatment of primary spontaneous pneumothorax:present, past and future. Hel J Surg. 2013;85(1):8-17.
  • 5. Hatz RA, Kaps MF, Meimarakis G, Loehe F, Muller C, Furst H. Long-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax. Ann Thorac Surg 2000;70:253–7.
  • 6. Sihoe ADL, Yu PSY, Yeung JWL. Primary pneumothorax: Should surgery be offered after the first episode? World J Respirol 2015;5(1):47-57.
  • 7. Joshi V, B Kirmani, J Zacharias. Thoracotomy versus VATS: is there an optimal approach to treating pneumothorax? Ann R Coll Surg Engl. 2013;95:61–4.
  • 8. Bagheri R, Haghi SZ, Attaran D, Ebadi F, Rajabnejad Y, Rajabnejad A. Video-assisted thoracoscopic surgery versus axillary thoracotomy in primary spontaneous pneumothorax. J Cardiothor Med. 2017;5(1):538-42.
  • 9. Ng CSH, Lee TW, Wan S, Yim APC. Video assisted thoracic surgery in the management of spontaneous pneumothorax: the current status. Postgrad Med J. 2006;82:179–85.
  • 10. Gossot D, Galetta D, Stern JB, Debrosse D, Caliandro R, Girard P, et al. Results of thoracoscopic pleural abrasion for primary spontaneous pneumothorax. Surg Endosc 2004;18:466–71.
  • 11. Chen JS, Hsu HH, Kuo SW, Tsai PR, Chen RJ, Lee JM, et al. Effects of additional minocycline pleurodesis after thoracoscopic procedures for primary spontaneous pneumothorax. Chest. 2004;125:50–5.
  • 12. Doddoli C, Barlesi F, Fraticelli A, Thomas P, Astoul P, Giudicelli R, 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;26:889–92.
  • 13. Van Schil P. Cost analysis of video-assisted thoracic surgery versus thoracotomy: critical review. Eur Respir J. 2003; 22:735–8.
  • 14. Kim KH, Kim HK, Han JY, Kim JT, Wen YS, Choi SS. Transaxillary minithoracotomy versus video-assisted thoracic surgery for spontaneous pneumothorax. Ann Thorac Surg. 1996;61:1510–12.
  • 15. Pages PB, Delpy JP, Falcoz PE, Thomas PA, Filaire M, Le Pimpec BF, et al. Videothoracoscopy versus thoracotomy for the treatment of spontaneous pneumothorax: a propensity score analysis. Ann Thorac Surg. 2015;99:258–64.
  • 16. Hamada A, Oizumi H, Kato H, Suzuki J, Nakahashi K, Sho R, et al. Learning curve for port-access thoracoscopic anatomic lung segmentectomy. J Thorac Cardiovasc Surg. 2019;156(5):1995-2003.
  • 17. Cao C, Petersen RH, Yan TD. Learning curve for video-assisted thoracoscopic lobectomy. J Thorac Cardivasc Surg. 2014;147(5):1727.
  • 18. Chang CC, Yen YT, Lin CY, Chen YY, Huang WL, Tseng YL. Single-port video-assisted thoracoscopic surgery subsegmentectomy: The learning curve and initial outcome. Asian J Surg. 2020;43:625-32.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma makalesi
Yazarlar

Murat Sarıçam 0000-0003-3469-5798

Yayımlanma Tarihi 1 Nisan 2020
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

APA Sarıçam, M. (2020). Transaxillary mini thoracotomy as an alternative to thoracoscopy in the treatment of primary spontaneous pneumothorax: A prospective cohort study. Journal of Surgery and Medicine, 4(4), 293-295. https://doi.org/10.28982/josam.655089
AMA Sarıçam M. Transaxillary mini thoracotomy as an alternative to thoracoscopy in the treatment of primary spontaneous pneumothorax: A prospective cohort study. J Surg Med. Nisan 2020;4(4):293-295. doi:10.28982/josam.655089
Chicago Sarıçam, Murat. “Transaxillary Mini Thoracotomy As an Alternative to Thoracoscopy in the Treatment of Primary Spontaneous Pneumothorax: A Prospective Cohort Study”. Journal of Surgery and Medicine 4, sy. 4 (Nisan 2020): 293-95. https://doi.org/10.28982/josam.655089.
EndNote Sarıçam M (01 Nisan 2020) Transaxillary mini thoracotomy as an alternative to thoracoscopy in the treatment of primary spontaneous pneumothorax: A prospective cohort study. Journal of Surgery and Medicine 4 4 293–295.
IEEE M. Sarıçam, “Transaxillary mini thoracotomy as an alternative to thoracoscopy in the treatment of primary spontaneous pneumothorax: A prospective cohort study”, J Surg Med, c. 4, sy. 4, ss. 293–295, 2020, doi: 10.28982/josam.655089.
ISNAD Sarıçam, Murat. “Transaxillary Mini Thoracotomy As an Alternative to Thoracoscopy in the Treatment of Primary Spontaneous Pneumothorax: A Prospective Cohort Study”. Journal of Surgery and Medicine 4/4 (Nisan 2020), 293-295. https://doi.org/10.28982/josam.655089.
JAMA Sarıçam M. Transaxillary mini thoracotomy as an alternative to thoracoscopy in the treatment of primary spontaneous pneumothorax: A prospective cohort study. J Surg Med. 2020;4:293–295.
MLA Sarıçam, Murat. “Transaxillary Mini Thoracotomy As an Alternative to Thoracoscopy in the Treatment of Primary Spontaneous Pneumothorax: A Prospective Cohort Study”. Journal of Surgery and Medicine, c. 4, sy. 4, 2020, ss. 293-5, doi:10.28982/josam.655089.
Vancouver Sarıçam M. Transaxillary mini thoracotomy as an alternative to thoracoscopy in the treatment of primary spontaneous pneumothorax: A prospective cohort study. J Surg Med. 2020;4(4):293-5.