Surgical Treatment of Recurrent Spontaneous Pneumothorax: What Is the Optimal Timing?

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Sánchez de Cos Escuín, C. Disdier Vicente, J. Corral Peñafiel, J.A. Riesco Miranda, M.A. Sojo González, J.F. Masa Jiménez" "autores" => array:6 [ 0 => array:3 [ "preGrado" => "Dr" "nombre" => "J." "apellidos" => "Sánchez de Cos Escuín" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Disdier Vicente" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Corral Peñafiel" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Riesco Miranda" ] 4 => array:2 [ "nombre" => "M.A." "apellidos" => "Sojo González" ] 5 => array:2 [ "nombre" => "J.F." "apellidos" => "Masa Jiménez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906700970?idApp=UINPBA00003Z" "url" => "/15792129/0000004000000006/v1_201305150057/S1579212906700970/v1_201305150057/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Original Articles" "titulo" => "Surgical Treatment of Recurrent Spontaneous Pneumothorax: What Is the Optimal Timing?" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "275" "paginaFinal" => "278" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.E. Rivo Vázquez, M.A. Cañizares Carretero, E. García Fontán, J. Albort Ventura, R. Peñalver Pascual" "autores" => array:5 [ 0 => array:5 [ "preGrado" => "Dr" "nombre" => "J.E." "apellidos" => "Rivo Vázquez" "email" => array:1 [ 0 => "eduardorivo@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "M.A." "apellidos" => "Cañizares Carretero" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "García Fontán" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Albort Ventura" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Peñalver Pascual" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cirugía Torácica, Complexo Hospitalario Xeral-Cíes, Vigo, Pontevedra, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J.E. Rivo Vázquez. Servicio de Cirugía Torácica. Complexo Hospitalario Xeral-Cíes. Pizarro, 22. 36204 Vigo. Pontevedra. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-09-09" "fechaAceptado" => "2003-01-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec153439" "palabras" => array:3 [ 0 => "Spontaneous pneumothorax: recurrent, persistent" 1 => "Surgical indications" 2 => "Video-assisted thoracoscopic surgery (VATS)" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153440" "palabras" => array:3 [ 0 => "Neumotórax espontáneo recidivante" 1 => "Indicación quirúrgica" 2 => "Cirugía videotoracoscópica (CVT)" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "ObjectivesTo analyze the impact on the outcome of video-assisted thoracoscopic surgery (VATS) of delaying surgery in patients with previous episodes of pneumothorax. Material and methodWe studied 57 surgical procedures for recurrent primary spontaneous pneumothorax. The cases were grouped according to the medical history. One group comprised patients treated surgically at the first episode of contralateral pneumothorax or the second episode of ipsilateral pneumothorax. The second group comprised patients treated surgically at the third or successive episode. We compared the 2 groups as to number of thoracotomies, number of conversions from VATS to thoracotomy, presence of adhesions, and length of postoperative hospital stay. ResultsOf the total number of procedures, 13.9% were performed during the third or successive episode. In this group the number of pleuropulmonary adhesions and the percentage of thoracotomies (whether initially indicated or conversions from VATS) was significantly higher (P <.05). However, there was no difference between the 2 groups in length of postoperative stay. ConclusionsVATS is the technique of choice for the surgical treatment of recurrent primary spontaneous pneumothorax. Such treatment should be performed at the first episode of contralateral pneumothorax or the second episode of ipsilateral pneumothorax since delayed surgery gives rise to a higher incidence of technical difficulties that entail thoracotomies." ] "es" => array:1 [ "resumen" => "ObjetivosAnalizar la influencia del retraso en la indicación de cirugía, en términos de episodios de recidiva de neumotórax previos a la intervención, sobre los resultados de la cirugía videotoracoscópica (CVT). Material y métodosSe analizaron 57 procedimientos quirúrgicos llevados a cabo por neumotórax espontáneo primario de repetición. Estos procedimientos se dividieron en función de sus antecedentes. En un grupo se reunieron los intervenidos durante el primero (en el caso de neumotórax contralateral) o segundo episodios sobre el mismo hemitó-rax, y en otro los operados en el tercero o sucesivos. Entre ambos grupos se comparó el número de toracotomías, las conversiones de CVT a toracotomía, la presencia de adhe-rencias y la estancia postoperatoria. ResultadosEl 13,9% de los procedimientos se practicaron en el tercer episodio o siguientes. En este grupo de enfermos la frecuencia de adherencias pleuropulmorares y el porcentaje de toracotomías practicadas (ya fuera por indicación inicial o tras conversión de CVT) fue significativa-mente mayor (p < 0,05). Sin embargo, no se aprecian dife-rencias en cuanto a las estancias postoperatorias generadas por estos pacientes. ConclusionsLa CVT es la técnica de elección en el tra-tamiento quirúrgico del neumotórax espontáneo primario de repetición. La indicación quirúrgica en estos casos debe establecerse en el primero (neumotórax contralateral) o segundo episodios de neumotórax, dado que el retraso de la cirugía condiciona una mayor incidencia de dificultades técnicas que motiva un aumento del índice de toracotomías." ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normativa sobre diagnóstico y tratamiento del neumotórax" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Grupo de Trabajo SEPAR" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2002" "volumen" => "38" "paginaInicial" => "589" "paginaFinal" => "595" "link" => array:1 [ 0 => array:2 [ "url" => 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