Pneumothorax surgery: Difference between revisions
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==Indications== | ==Indications== | ||
*Surgical intervention is recommended for the management of pneumothorax.<ref name="pmid17502684">{{cite journal| author=Gudbjartsson T, Tómasdóttir GF, Björnsson J, Torfason B| title=[Spontaneous pneumothorax: a review article]. | journal=Laeknabladid | year= 2007 | volume= 93 | issue= 5 | pages= 415-24 | pmid=17502684 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17502684 }} </ref><ref name="pmid21213209">{{cite journal| author=Haynes D, Baumann MH| title=Management of pneumothorax. | journal=Semin Respir Crit Care Med | year= 2010 | volume= 31 | issue= 6 | pages= 769-80 | pmid=21213209 | doi=10.1055/s-0030-1269837 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21213209 }} </ref> | *Surgical intervention is recommended for the management of pneumothorax.<ref name="pmid17502684">{{cite journal| author=Gudbjartsson T, Tómasdóttir GF, Björnsson J, Torfason B| title=[Spontaneous pneumothorax: a review article]. | journal=Laeknabladid | year= 2007 | volume= 93 | issue= 5 | pages= 415-24 | pmid=17502684 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17502684 }} </ref><ref name="pmid21213209">{{cite journal| author=Haynes D, Baumann MH| title=Management of pneumothorax. | journal=Semin Respir Crit Care Med | year= 2010 | volume= 31 | issue= 6 | pages= 769-80 | pmid=21213209 | doi=10.1055/s-0030-1269837 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21213209 }} </ref><ref name="pmid22191997">{{cite journal| author=Galbois A, Zorzi L, Meurisse S, Kernéis S, Margetis D, Alves M et al.| title=Outcome of spontaneous and iatrogenic pneumothoraces managed with small-bore chest tubes. | journal=Acta Anaesthesiol Scand | year= 2012 | volume= 56 | issue= 4 | pages= 507-12 | pmid=22191997 | doi=10.1111/j.1399-6576.2011.02602.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22191997 }} </ref> | ||
Management of pneumothorax depends on the following factors: | Management of pneumothorax depends on the following factors: | ||
* Size of the pneumothorax | * Size of the pneumothorax |
Revision as of 16:18, 16 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
Surgical intervention is not recommended for the management of [disease name].
OR
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
OR
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
OR
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
Surgery is the mainstay of treatment for [disease or malignancy].
Indications
Management of pneumothorax depends on the following factors:
- Size of the pneumothorax
- Underlying disease/procedure causing pneumothorax
- Associated comorbid condition
- Type of pneumothorax (open/closed vs simple/tension)
First aid
- In all patients with chest trauma along with respiratory difficulty, following measures ahould be taken as the first line management.
- Maintaining the airway patency
- Assessment of breathing
- Prevention of circulatory collapse
- Oxygen therapy
- Patient should be positioned upright, unless there is a contraindication to it, such as spinal injury.
Oxygen therapy
- Immediate administration of 100% oxygen results in acclereated resorption of pleural air.[4]
Surgical techniques
Following surgical techniques are used to treat pneumothorax:
- Open thoracotomy
- Video-assisted thoracoscopic (VATS)
Surgery
- Open thoracotomy used to be the most commonly used surgical procedure along with wedge resection of the leaking part of the lung.
- Nowadays, video-assisted thoracoscopic (VATS) surgery has widely replaced the open surgical procedure for spontaneous pneumothorax.
Tube thoracotomy
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Complications of the procedure
- Injury to lung or mediastinum,
- Excessive bleeding most likely from intercostal artery injury
- Neurovascular bundle injury
- Infection
- Bronchopleural fistula
Contraindications
References
- ↑ Gudbjartsson T, Tómasdóttir GF, Björnsson J, Torfason B (2007). "[Spontaneous pneumothorax: a review article]". Laeknabladid. 93 (5): 415–24. PMID 17502684.
- ↑ Haynes D, Baumann MH (2010). "Management of pneumothorax". Semin Respir Crit Care Med. 31 (6): 769–80. doi:10.1055/s-0030-1269837. PMID 21213209.
- ↑ Galbois A, Zorzi L, Meurisse S, Kernéis S, Margetis D, Alves M; et al. (2012). "Outcome of spontaneous and iatrogenic pneumothoraces managed with small-bore chest tubes". Acta Anaesthesiol Scand. 56 (4): 507–12. doi:10.1111/j.1399-6576.2011.02602.x. PMID 22191997.
- ↑ Chadha TS, Cohn MA (1983). "Noninvasive treatment of pneumothorax with oxygen inhalation". Respiration. 44 (2): 147–52. PMID 6836190.