Original Articles
Effectiveness and Complications of Video-Assisted Surgery for Primary Spontaneous Pneumothorax
A. Gómez-Caro
, F.J. Moradiellos, E. Larrú, V. Díaz-Hellín, C. Marrón, J.A. Pérez-Antón, J.L. Martín de Nicolás
Corresponding author
abelitov@yahoo.es
Correspondence: Dr. A. Gómez-Caro. Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Ctra. de Andalucía, km 5,4. 28041 Madrid. España
Correspondence: Dr. A. Gómez-Caro. Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Ctra. de Andalucía, km 5,4. 28041 Madrid. España
Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain
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Medrano, A. Mainar, E.R. Alfonso, M. Rengel" "autores" => array:5 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "M.A." "apellidos" => "de Gregorio" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Medrano" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Mainar" ] 3 => array:2 [ "nombre" => "E.R." "apellidos" => "Alfonso" ] 4 => array:2 [ "nombre" => "M." 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"apellidos" => "Gómez-Caro" "email" => array:1 [ 0 => "abelitov@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "F.J." "apellidos" => "Moradiellos" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Larrú" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Díaz-Hellín" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Marrón" ] 5 => array:2 [ "nombre" => "J.A." "apellidos" => "Pérez-Antón" ] 6 => array:2 [ "nombre" => "J.L." "apellidos" => "Martín de Nicolás" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. A. Gómez-Caro. Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Ctra. de Andalucía, km 5,4. 28041 Madrid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-03-01" "fechaAceptado" => "2005-05-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154238" "palabras" => array:4 [ 0 => "Pneumothorax" 1 => "Video-assisted thoracoscopy" 2 => "Complications" 3 => "Recurrence" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154239" "palabras" => array:5 [ 0 => "Neumotórax" 1 => "VATS" 2 => "Complicaciones" 3 => "Morbilidad" 4 => "Recidiva" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To assess the effectiveness and describe the complications of video-assisted thoracoscopic surgery (VATS) for the treatment of primary spontaneous pneumothorax.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Between May 1997 and September 2003, our department scheduled 147 VATS procedures for spontaneous pneumothorax in 127 patients (102 men [80.5%]). The mean (SD) age for the series was 28.3 (11.6) years. Bullae and blebs were resected by endostapler and vigorous pleural abrasion was carried out. Vanderschueren staging was as follows: stage I, 10 (6.8%); stage II, 22 (15%); stage III, 71 (48.3%); and stage IV, 44 (29.9%). The procedure was indicated for the following reasons: third episode, 56 (38.1%); persistent air leak, 47 (32%); elective, 16 (10.9%); simultaneous bilateral pneumothorax, 28 (19%). VATS was performed on the right side only in 85 patients (57.8%), on the left in 62 (42.2%), and on both sides in 16 (11.6%).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 137 of the 147 VATS procedures scheduled (93.2%) were performed, and there were no deaths. The rate of conversion to thoracotomy was 6.8%, and the overall rate of complications was 13.7%. Postoperative complications were due to bleeding in 5 cases (3.6%), air leak (>5 days) in 10 (7.2%), wound infection in 2 (1.4%), residual pneumothorax in 4 (2.9%), need to insert a new pleural drain in 3 (2.1%), and pleural empyema in 1 (0.7%). Two patients took oral analgesics for more than 30 days after the procedure. Pneumothorax recurred during follow-up in 7 patients (5.1%). No significant correlation was found between recurrence of pneumothorax after VATS and Vandeschueren stage, age, bilaterality of the procedure, indication, or days of postoperative drainage (P>.05).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">VATS for resection of pleural lesions plus pleural abrasion is an efficacious and simple treatment for primary spontaneous pneumothorax regardless of intraoperative findings.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Evaluar y describir la eficacia y la morbilidad de la VATS (<span class="elsevierStyleItalic">video assisted toracic surgery</span> [cirugía torácica videoasistida]) en el tratamiento del neumotórax espontáneo primario (NEP).</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Entre mayo de 1997 y septiembre de 2003 se programaron en nuestro servicio 147 intervenciones por NEP para VATS en 127 pacientes. Las lesiones bullosas se resecaron mediante endograpadoras. Posteriormente se realizó pleuroabrasión vigorosa. La estadificación según Vanderschueren resultó: estadio I, 10 (6,8%); II, 22 (15%); III, 71 (48,3%), y IV, 44 (29,9%). Se intervino a 102 (80,5%) hombres y 25 (19,5%) mujeres. La media de edad fue de 28,3 ± 11,6 años. Las indicaciones fueron: tercer episodio, 56 (38,1%); fuga aérea persistente, 47 (32%); cirugía electiva, 16 (10,9%); neumotórax bilateral sincrónico, 28 (19%). Se realizó VATS en el lado derecho en 85 pacientes (57,8%) y en el izquierdo en 62 (42,2%). Se realizó intervención bilateral en 16 (11,6%).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se realizaron 137 VATS (93,2%). No hubo mortalidad y la tasa de reconversión fue del 6,8%. La incidencia de complicaciones fue del 13,7%. La morbilidad post-operatoria fue: sangrado en 5 pacientes (3,6%); fuga aérea (> 5 días) en 10 (7,2%); infección de herida en 2 (1,4%); neumotórax residual en 4 (2,9%); nuevo drenaje torácico en 3 (2,1%), y empiema pleural en 1 (0,7%). Dos pacientes tomaron analgésicos orales durante más de 30 días después del procedimiento. La recurrencia en seguimiento fue de 7 (5,1%). Se analizó el índice de recurrencia post VATS en relación al estadio Vandeschueren, la edad, el carácter bilateral del neumotórax, la indicación o los días de drenaje post-operatorio y no se encontraron diferencias significativas (p > 0,05).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La VATS con resección de lesiones y pleuroabrasión es un método eficaz y sencillo independiente de los hallazgos intraoperatorios para el tratamiento del NPE.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bilateral bleb excision through median sternotomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "JF Neal" 1 => "G Vargas" 2 => "DE Smith" 3 => "BF Akl" 4 => "WS Edwards" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Surg" "fecha" => "1979" "volumen" => "138" "paginaInicial" => "794" "paginaFinal" => "797" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/507294" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy study of video-assisted thoracoscopic surgery pleurodesis for spontaneous pneumothorax" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P Chan" 1 => "P Clarke" 2 => "FJ Daniel" 3 => "SR Knight" 4 => "S Seevanayagam" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2001" "volumen" => "71" "paginaInicial" => "452" "paginaFinal" => "454" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11235687" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Video-assisted thoracoscopic treatment of spontaneous pneumothorax: technique and results of one hundred cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J Mouroux" 1 => "D Elkaim" 2 => "B Padovani" 3 => "A Myx" 4 => "C Perrin" 5 => "C Rotomondo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0022-5223(96)70266-0" "Revista" => array:6 [ "tituloSerie" => "J Thorac Cardiovasc Surg" "fecha" => "1996" "volumen" => "112" "paginaInicial" => "385" "paginaFinal" => "391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8751507" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "RA Hatz" 1 => "MF Kaps" 2 => "G Meimarakis" 3 => "F Loehe" 4 => "C Muller" 5 => "H Furst" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2000" "volumen" => "70" "paginaInicial" => "253" "paginaFinal" => "257" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10921718" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is video-assisted thoracic surgery justified at first spontaneous pneumothorax?" 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 1 | 7 |
| 2024 October | 47 | 14 | 61 |
| 2024 September | 41 | 15 | 56 |
| 2024 August | 52 | 36 | 88 |
| 2024 July | 29 | 26 | 55 |
| 2024 June | 43 | 22 | 65 |
| 2024 May | 56 | 31 | 87 |
| 2024 April | 19 | 20 | 39 |
| 2024 March | 26 | 21 | 47 |
| 2024 February | 27 | 14 | 41 |
| 2023 March | 2 | 3 | 5 |
| 2023 February | 14 | 14 | 28 |
| 2023 January | 16 | 22 | 38 |
| 2022 December | 20 | 26 | 46 |
| 2022 November | 19 | 14 | 33 |
| 2022 October | 25 | 31 | 56 |
| 2022 September | 14 | 34 | 48 |
| 2022 August | 21 | 30 | 51 |
| 2022 July | 15 | 38 | 53 |
| 2022 June | 13 | 31 | 44 |
| 2022 May | 17 | 32 | 49 |
| 2022 April | 12 | 20 | 32 |
| 2022 March | 15 | 44 | 59 |
| 2022 February | 16 | 31 | 47 |
| 2022 January | 15 | 30 | 45 |
| 2021 December | 18 | 46 | 64 |
| 2021 November | 13 | 44 | 57 |
| 2021 October | 18 | 49 | 67 |
| 2021 September | 18 | 42 | 60 |
| 2021 August | 11 | 29 | 40 |
| 2021 July | 14 | 33 | 47 |
| 2021 June | 9 | 17 | 26 |
| 2021 May | 14 | 29 | 43 |
| 2021 April | 22 | 63 | 85 |
| 2021 March | 19 | 15 | 34 |
| 2021 February | 8 | 17 | 25 |
| 2021 January | 12 | 11 | 23 |
| 2020 December | 9 | 16 | 25 |
| 2020 November | 11 | 8 | 19 |
| 2020 October | 2 | 4 | 6 |
| 2020 September | 3 | 6 | 9 |
| 2020 August | 11 | 6 | 17 |
| 2020 July | 8 | 17 | 25 |
| 2020 June | 6 | 4 | 10 |
| 2020 May | 18 | 14 | 32 |
| 2020 April | 10 | 9 | 19 |
| 2020 March | 12 | 7 | 19 |
| 2020 February | 9 | 8 | 17 |
| 2020 January | 17 | 12 | 29 |
| 2019 December | 11 | 16 | 27 |
| 2019 November | 7 | 7 | 14 |
| 2019 October | 5 | 6 | 11 |
| 2019 September | 12 | 6 | 18 |
| 2019 August | 16 | 4 | 20 |
| 2019 July | 17 | 10 | 27 |
| 2019 June | 7 | 2 | 9 |
| 2019 May | 13 | 5 | 18 |
| 2019 April | 12 | 14 | 26 |
| 2019 March | 15 | 20 | 35 |
| 2019 February | 13 | 6 | 19 |
| 2019 January | 10 | 9 | 19 |
| 2018 December | 9 | 14 | 23 |
| 2018 November | 11 | 10 | 21 |
| 2018 October | 16 | 14 | 30 |
| 2018 September | 12 | 14 | 26 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 6 | 9 | 15 |
| 2018 March | 5 | 2 | 7 |
| 2018 February | 4 | 9 | 13 |
| 2018 January | 8 | 10 | 18 |
| 2017 December | 2 | 7 | 9 |
| 2017 November | 6 | 8 | 14 |
| 2017 October | 8 | 8 | 16 |
| 2017 September | 4 | 5 | 9 |
| 2017 August | 8 | 16 | 24 |
| 2017 July | 5 | 7 | 12 |
| 2017 June | 6 | 26 | 32 |
| 2017 May | 9 | 13 | 22 |
| 2017 April | 3 | 6 | 9 |
| 2017 March | 3 | 6 | 9 |
| 2017 February | 3 | 4 | 7 |
| 2017 January | 1 | 0 | 1 |
| 2016 December | 6 | 7 | 13 |
| 2016 November | 12 | 8 | 20 |
| 2016 October | 7 | 8 | 15 |
| 2016 September | 12 | 13 | 25 |
| 2016 August | 7 | 3 | 10 |
| 2016 July | 7 | 0 | 7 |
| 2016 March | 3 | 0 | 3 |
| 2016 February | 1 | 0 | 1 |
| 2016 January | 1 | 0 | 1 |
| 2015 December | 1 | 0 | 1 |
| 2015 October | 213 | 15 | 228 |
| 2015 September | 195 | 10 | 205 |
| 2015 August | 173 | 9 | 182 |
| 2015 July | 213 | 7 | 220 |
| 2015 June | 126 | 12 | 138 |
| 2015 May | 161 | 12 | 173 |
| 2015 April | 200 | 6 | 206 |
| 2015 March | 181 | 12 | 193 |
| 2015 February | 156 | 9 | 165 |
| 2015 January | 139 | 12 | 151 |
| 2014 December | 169 | 11 | 180 |
| 2014 November | 145 | 3 | 148 |
| 2014 October | 184 | 13 | 197 |
| 2014 September | 135 | 10 | 145 |
| 2014 August | 154 | 5 | 159 |
| 2014 July | 129 | 10 | 139 |
| 2014 June | 129 | 7 | 136 |
| 2014 May | 117 | 8 | 125 |
| 2014 April | 91 | 9 | 100 |
| 2014 March | 99 | 10 | 109 |
| 2014 February | 84 | 9 | 93 |
| 2014 January | 69 | 8 | 77 |
| 2013 December | 56 | 8 | 64 |
| 2013 November | 46 | 8 | 54 |
| 2013 October | 51 | 14 | 65 |
| 2013 September | 33 | 12 | 45 |
| 2013 August | 52 | 10 | 62 |
| 2013 July | 52 | 12 | 64 |
| 2013 June | 46 | 10 | 56 |
| 2013 May | 51 | 5 | 56 |
| 2013 April | 35 | 5 | 40 |
| 2013 March | 10 | 1 | 11 |
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