Awake thoracic surgery versus chemical pleurodesis for intractable secondary spontaneous pneumothorax

Masafumi Noda, Tatsuaki Watanabe, Yasushi Matsuda, Akira Sakurada, Yasushi Hoshikawa, Yoshinori Okada

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To compare the outcomes and efficacy of awake video-assisted thoracic surgery (VATS) with those of chemical pleurodesis for intractable secondary spontaneous pneumothorax (SSP). Methods: We analyzed, retrospectively, 60 consecutive patients who underwent awake VATS (n = 22) or chemical pleurodesis (n = 38) for SSP. Using propensity score matching, we identified comparable patient groups (n = 12 each): the awake VATS group and the chemical pleurodesis group. We compared hematologic data on postoperative day 1, postoperative complications including respiratory complications, and the maximum score on the verbal rating scale (VRS) between the groups. Next, we identified comparable patient groups (n = 8 each) for those with controlled air leak after treatment, but not for those with a prolonged air leak. We analyzed data about the day of air leak control, intra-thoracic drainage, and hospital stay to compare awake VATS vs. chemical pleurodesis. Results: After propensity score matching, the rates of recurrent pneumothorax and prolonged air leaks after conservative or surgical treatment were not significantly different. The C-reactive protein level and the VRS score were significantly lower in the awake VATS group. The duration of prolonged air leak, and drainage after treatment were significantly shorter in the awake VATS group. The postoperative hospital stay and the incidence of postoperative complications did not differ between the groups. Conclusions: We advocate that awake VATS, performed by a skilled thoracic surgeon, is a more feasible surgical option than chemical pleurodesis for patients with intractable SSP.

Original languageEnglish
Pages (from-to)1268-1274
Number of pages7
JournalSurgery Today
Volume46
Issue number11
DOIs
Publication statusPublished - 01-11-2016

Fingerprint

Pleurodesis
Video-Assisted Thoracic Surgery
Pneumothorax
Thoracic Surgery
Air
Propensity Score
Drainage
Length of Stay
Thorax
C-Reactive Protein
Therapeutics
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Noda, Masafumi ; Watanabe, Tatsuaki ; Matsuda, Yasushi ; Sakurada, Akira ; Hoshikawa, Yasushi ; Okada, Yoshinori. / Awake thoracic surgery versus chemical pleurodesis for intractable secondary spontaneous pneumothorax. In: Surgery Today. 2016 ; Vol. 46, No. 11. pp. 1268-1274.
@article{e1c074e2f0a84670ae1873069b5f03ef,
title = "Awake thoracic surgery versus chemical pleurodesis for intractable secondary spontaneous pneumothorax",
abstract = "Purpose: To compare the outcomes and efficacy of awake video-assisted thoracic surgery (VATS) with those of chemical pleurodesis for intractable secondary spontaneous pneumothorax (SSP). Methods: We analyzed, retrospectively, 60 consecutive patients who underwent awake VATS (n = 22) or chemical pleurodesis (n = 38) for SSP. Using propensity score matching, we identified comparable patient groups (n = 12 each): the awake VATS group and the chemical pleurodesis group. We compared hematologic data on postoperative day 1, postoperative complications including respiratory complications, and the maximum score on the verbal rating scale (VRS) between the groups. Next, we identified comparable patient groups (n = 8 each) for those with controlled air leak after treatment, but not for those with a prolonged air leak. We analyzed data about the day of air leak control, intra-thoracic drainage, and hospital stay to compare awake VATS vs. chemical pleurodesis. Results: After propensity score matching, the rates of recurrent pneumothorax and prolonged air leaks after conservative or surgical treatment were not significantly different. The C-reactive protein level and the VRS score were significantly lower in the awake VATS group. The duration of prolonged air leak, and drainage after treatment were significantly shorter in the awake VATS group. The postoperative hospital stay and the incidence of postoperative complications did not differ between the groups. Conclusions: We advocate that awake VATS, performed by a skilled thoracic surgeon, is a more feasible surgical option than chemical pleurodesis for patients with intractable SSP.",
author = "Masafumi Noda and Tatsuaki Watanabe and Yasushi Matsuda and Akira Sakurada and Yasushi Hoshikawa and Yoshinori Okada",
year = "2016",
month = "11",
day = "1",
doi = "10.1007/s00595-016-1309-5",
language = "English",
volume = "46",
pages = "1268--1274",
journal = "Surgery Today",
issn = "0941-1291",
publisher = "Springer Japan",
number = "11",

}

Awake thoracic surgery versus chemical pleurodesis for intractable secondary spontaneous pneumothorax. / Noda, Masafumi; Watanabe, Tatsuaki; Matsuda, Yasushi; Sakurada, Akira; Hoshikawa, Yasushi; Okada, Yoshinori.

In: Surgery Today, Vol. 46, No. 11, 01.11.2016, p. 1268-1274.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Awake thoracic surgery versus chemical pleurodesis for intractable secondary spontaneous pneumothorax

AU - Noda, Masafumi

AU - Watanabe, Tatsuaki

AU - Matsuda, Yasushi

AU - Sakurada, Akira

AU - Hoshikawa, Yasushi

AU - Okada, Yoshinori

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Purpose: To compare the outcomes and efficacy of awake video-assisted thoracic surgery (VATS) with those of chemical pleurodesis for intractable secondary spontaneous pneumothorax (SSP). Methods: We analyzed, retrospectively, 60 consecutive patients who underwent awake VATS (n = 22) or chemical pleurodesis (n = 38) for SSP. Using propensity score matching, we identified comparable patient groups (n = 12 each): the awake VATS group and the chemical pleurodesis group. We compared hematologic data on postoperative day 1, postoperative complications including respiratory complications, and the maximum score on the verbal rating scale (VRS) between the groups. Next, we identified comparable patient groups (n = 8 each) for those with controlled air leak after treatment, but not for those with a prolonged air leak. We analyzed data about the day of air leak control, intra-thoracic drainage, and hospital stay to compare awake VATS vs. chemical pleurodesis. Results: After propensity score matching, the rates of recurrent pneumothorax and prolonged air leaks after conservative or surgical treatment were not significantly different. The C-reactive protein level and the VRS score were significantly lower in the awake VATS group. The duration of prolonged air leak, and drainage after treatment were significantly shorter in the awake VATS group. The postoperative hospital stay and the incidence of postoperative complications did not differ between the groups. Conclusions: We advocate that awake VATS, performed by a skilled thoracic surgeon, is a more feasible surgical option than chemical pleurodesis for patients with intractable SSP.

AB - Purpose: To compare the outcomes and efficacy of awake video-assisted thoracic surgery (VATS) with those of chemical pleurodesis for intractable secondary spontaneous pneumothorax (SSP). Methods: We analyzed, retrospectively, 60 consecutive patients who underwent awake VATS (n = 22) or chemical pleurodesis (n = 38) for SSP. Using propensity score matching, we identified comparable patient groups (n = 12 each): the awake VATS group and the chemical pleurodesis group. We compared hematologic data on postoperative day 1, postoperative complications including respiratory complications, and the maximum score on the verbal rating scale (VRS) between the groups. Next, we identified comparable patient groups (n = 8 each) for those with controlled air leak after treatment, but not for those with a prolonged air leak. We analyzed data about the day of air leak control, intra-thoracic drainage, and hospital stay to compare awake VATS vs. chemical pleurodesis. Results: After propensity score matching, the rates of recurrent pneumothorax and prolonged air leaks after conservative or surgical treatment were not significantly different. The C-reactive protein level and the VRS score were significantly lower in the awake VATS group. The duration of prolonged air leak, and drainage after treatment were significantly shorter in the awake VATS group. The postoperative hospital stay and the incidence of postoperative complications did not differ between the groups. Conclusions: We advocate that awake VATS, performed by a skilled thoracic surgeon, is a more feasible surgical option than chemical pleurodesis for patients with intractable SSP.

UR - http://www.scopus.com/inward/record.url?scp=84958777694&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84958777694&partnerID=8YFLogxK

U2 - 10.1007/s00595-016-1309-5

DO - 10.1007/s00595-016-1309-5

M3 - Article

C2 - 26883370

AN - SCOPUS:84958777694

VL - 46

SP - 1268

EP - 1274

JO - Surgery Today

JF - Surgery Today

SN - 0941-1291

IS - 11

ER -