Video-assisted Thoracoscopic Surgery for Primary Spontaneous Pneumothorax in Children

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2013 Feb 13

PMID 23400267

Citations 17

Authors

Si Young Choi

Yong Hwan Kim

Keon Hyon Jo

Chi Kyung Kim

Jae Kil Park

Deog Gon Cho

Seong Cheol Jeong

Hyun Woo Jeon

Chan Beom Park

Affiliations

Soon will be listed here.

Abstract

Purpose: There is controversy regarding the best way to prevent recurrences of primary spontaneous pneumothorax (PSP) in children. The purpose of this study was to evaluate the efficacy of video-assisted thoracoscopic surgery (VATS) for pediatric PSP.

Methods: We retrospectively reviewed patients under 29 years of age who underwent VATS for PSP between March 2005 and February 2011. Patients were divided into 2 groups: children (under the age of 17 years) and young adults (over the age of 18 years).

Results: Two hundred eighty-one VATS procedures in 257 patients were included in this study. The mean follow-up was 47.1 ± 20.5 months. No mortality was observed. The mean duration of pleural drainage was 3.4 ± 2.2 days. The overall recurrence rate was 6.8 %. The operative outcomes did not differ significantly. However, the recurrence rate was significantly higher in the children's group than the young adult group (10.6 vs. 3.9 %, P = 0.032). Younger age and postoperative prolonged air leak had a significantly higher risk of postoperative recurrence.

Conclusions: VATS is a safe and effective procedure for PSP in children. However, the risk of recurrence is increased in children and it is related to the formation of new bullae.

Citing Articles

Spontaneous pneumothorax in children: a radiological perspective.

Ozkale Yavuz O, Ayaz E, Ozcan H, Oguz B, Haliloglu M Pediatr Radiol. 2024; 54(11):1864-1872.

PMID: 39283326 DOI: 10.1007/s00247-024-06053-w.

Use of Video-Assisted Thoracoscopic Surgery (VATS) in the Treatment of Primary Spontaneous Pneumothorax (PSP) in Children.

Sahin C, Ayyildiz H, Mirapoglu S, Guvenc F, Akis Yildiz Z, Arpacik M Cureus. 2023; 15(7):e42624.

PMID: 37641772 PMC: 10460625. DOI: 10.7759/cureus.42624.

Risk factors for the recurrence of primary spontaneous pneumothorax after video-assisted thoracoscopic surgery in patients younger than 40 years.

Shigenobu T, Ohtsuka T, Yoshizu A J Thorac Dis. 2023; 15(7):3783-3790.

PMID: 37559612 PMC: 10407527. DOI: 10.21037/jtd-23-257.

Intraoperative OK-432 pleurodesis for preventing recurrence of primary spontaneous pneumothorax in children and adolescents: a single-center experience.

Huang H, Lin Y, Chang P, Wang N, Sheu J Pediatr Surg Int. 2022; 39(1):66.

PMID: 36575307 DOI: 10.1007/s00383-022-05347-0.

Management of Primary Spontaneous Pneumothorax in a Third-Level Pediatric Surgical Center: A Retrospective Study.

Spezzotto G, Boscarelli A, Giangreco M, Ceschiutti G, Codrich D, Scarpa M Front Pediatr. 2022; 10:945641.

PMID: 35832585 PMC: 9271819. DOI: 10.3389/fped.2022.945641.

References

Abolnik I, Lossos I, Gillis D, Breuer R . Primary spontaneous pneumothorax in men. Am J Med Sci. 1993; 305(5):297-303. DOI: 10.1097/00000441-199305000-00006. View

Robinson P, Cooper P, Ranganathan S . Evidence-based management of paediatric primary spontaneous pneumothorax. Paediatr Respir Rev. 2009; 10(3):110-7. DOI: 10.1016/j.prrv.2008.12.003. View

Sahn S, Heffner J . Spontaneous pneumothorax. N Engl J Med. 2000; 342(12):868-74. DOI: 10.1056/NEJM200003233421207. View

Sakamoto K, Takei H, Nishii T, Maehara T, Omori T, Tajiri M . Staple line coverage with absorbable mesh after thoracoscopic bullectomy for spontaneous pneumothorax. Surg Endosc. 2004; 18(3):478-81. DOI: 10.1007/s00464-003-8918-y. View

Lippert H, Lund O, Blegvad S, Larsen H . Independent risk factors for cumulative recurrence rate after first spontaneous pneumothorax. Eur Respir J. 1991; 4(3):324-31. View

Hatz R, Kaps M, 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(1):253-7. DOI: 10.1016/s0003-4975(00)01411-9. View

Chambers A, Scarci M . In patients with first-episode primary spontaneous pneumothorax is video-assisted thoracoscopic surgery superior to tube thoracostomy alone in terms of time to resolution of pneumothorax and incidence of recurrence?. Interact Cardiovasc Thorac Surg. 2009; 9(6):1003-8. DOI: 10.1510/icvts.2009.216473. View

Freixinet J, Canalis E, Rivas J, Rodriguez de Castro F, Torres J, Gimferrer J . Surgical treatment of primary spontaneous pneumothorax with video-assisted thoracic surgery. Eur Respir J. 1997; 10(2):409-11. DOI: 10.1183/09031936.97.10020409. View

Bialas R, Weiner T, Phillips J . Video-assisted thoracic surgery for primary spontaneous pneumothorax in children: is there an optimal technique?. J Pediatr Surg. 2008; 43(12):2151-5. DOI: 10.1016/j.jpedsurg.2008.08.041. View

10.

Lang-Lazdunski L, Chapuis O, Bonnet P, Pons F, Jancovici R . Videothoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term results. Ann Thorac Surg. 2003; 75(3):960-5. DOI: 10.1016/s0003-4975(02)04544-7. View

11.

ORourke J, Yee E . Civilian spontaneous pneumothorax. Treatment options and long-term results. Chest. 1989; 96(6):1302-6. DOI: 10.1378/chest.96.6.1302. View

12.

Butterworth S, Blair G, Leblanc J, Skarsgard E . An open and shut case for early VATS treatment of primary spontaneous pneumothorax in children. Can J Surg. 2007; 50(3):171-4. PMC: 2384276. View

13.

MacDuff A, Arnold A, Harvey J . Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010; 65 Suppl 2:ii18-31. DOI: 10.1136/thx.2010.136986. View

14.

Park J, Han W, Kim H, Choi Y . Pleural abrasion for mechanical pleurodesis in surgery for primary spontaneous pneumothorax: is it effective?. Surg Laparosc Endosc Percutan Tech. 2012; 22(1):62-4. DOI: 10.1097/SLE.0b013e31823cc61e. View

15.

Bense L, Eklund G, WIMAN L . Bilateral bronchial anomaly. A pathogenetic factor in spontaneous pneumothorax. Am Rev Respir Dis. 1992; 146(2):513-6. DOI: 10.1164/ajrccm/146.2.513. View

16.

Qureshi F, Sandulache V, Richardson W, Ergun O, Ford H, Hackam D . Primary vs delayed surgery for spontaneous pneumothorax in children: which is better?. J Pediatr Surg. 2005; 40(1):166-9. DOI: 10.1016/j.jpedsurg.2004.09.042. View

17.

Ozcan C, McGahren E, Rodgers B . Thoracoscopic treatment of spontaneous pneumothorax in children. J Pediatr Surg. 2003; 38(10):1459-64. DOI: 10.1016/s0022-3468(03)00496-2. View

18.

Fujino S, Inoue S, Tezuka N, Hanaoka J, Sawai S, Ichinose M . Physical development of surgically treated patients with primary spontaneous pneumothorax. Chest. 1999; 116(4):899-902. DOI: 10.1378/chest.116.4.899. View

19.

Seguier-Lipszyc E, Elizur A, Klin B, Vaiman M, Lotan G . Management of primary spontaneous pneumothorax in children. Clin Pediatr (Phila). 2011; 50(9):797-802. DOI: 10.1177/0009922811404699. View

20.

Chung P, Wong K, Lan L, Tam P . Thoracoscopic bullectomy for primary spontaneous pneumothorax in pediatric patients. Pediatr Surg Int. 2009; 25(9):763-6. DOI: 10.1007/s00383-009-2432-9. View