Publication: Clinical Profile of Thoracoscopic Bullectomy in Treatment of Pneumothorax
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Health Research Council
Abstract
Background: In pneumothorax patients requiring surgery for various indications, thoracotomy was the traditional approach until the advent of video-assisted thoracoscopic surgery. In the last decade, role of thoracoscopy in the surgical management of pneumothorax has been consolidated and established. In this study, we aim to report our experience of thoracoscopy in the surgical management of pneumothorax.
Methods: A descriptive review of prospectively maintained data on all the patients undergoing thoracoscopic bullectomy for pneumothorax was done.
Result: Over the period of 9 years, a total of 120 patients underwent thoracoscopic bullectomy. Among them, 95 entered final analysis. Most common age group was 21-40 years, with male predominance (80%); most common diagnosis was primary pneumothorax (67%), first episode (74%), and on the right (65%) side; commonest symptom was shortness of breath (84%) of a median duration of 7 days. A chest tube was placed in 96% of patients before the operation. Commonest radiological finding was multiple bullae (45%) in the apical region (71%). Majority of patients underwent surgery via 3 ports, and a single bulla in the apical region was the most common intraoperative finding. Among the postoperative complications which occurred in 17%, an air leak was present in 9%. The median intensive care stay was 23 hours, the median chest tube duration was 3 days, and the median hospital stay was 9 days.
Conclusions: Thoracoscopy can be used as a safe, feasible, and effective procedure in patients presenting with pneumothorax with minimal postoperative complications.
Keywords: Bullectomy; pneumothorax; video-assisted thoracoscopic surgery.
Description
Pratima Gautam
Department of Surgery, Patan Academy of Health Sciences, Lalitpur, Nepal
https://orcid.org/0000-0003-3939-3705
Ranjan Sapkota
Department of Cardio-Thoracic and Vascular Surgery, Manmohan Cardio-Thoracic Vascular and Transplant Center, Institute of Medicine, Kathmandu, Nepal
https://orcid.org/0000-0003-0107-2148
Suraj Shrestha
Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
https://orcid.org/0000-0001-6888-260X
Prakash Mainali
Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
https://orcid.org/0000-0001-6307-5497