Medical Science
Minimally invasive thoracoscopic surgery for spontaneous pneumothorax Yu Zigang, Department of Thoracic Surgery, Shanwei People’s Hospital
Overview
Spontaneous pneumothorax is one of the common emergencies in thoracic medicine, mostly due to rupture of pulmonary alveoli, and is prone to recurrence.
According to statistics, the possibility of recurrence of spontaneous pneumothorax within 2 years is 30-50%; the recurrence rate rises to 75% for those who still perform conservative treatment for the second attack; if the third attack occurs, 100% of the attacks occur for the fourth time.
There are no specific triggers for spontaneous pneumothorax, and more than 80% of patients have an attack at rest or in daily life, while only about 9% have an attack when they are exercising.
Some of the larger alveoli do not necessarily rupture and cause pneumothorax, but because of their large size, they can compress normal lung tissue or even the heart and cause chest tightness, shortness of breath and other discomfort, and once they rupture, the danger is even more serious. For such patients, as long as the diagnosis is confirmed, even if it does not cause pneumothorax, it should be treated by minimally invasive thoracoscopic surgery in time to avoid future problems.
Clinical manifestations
The main manifestations are dyspnea, chest pain on the affected side, irritating dry cough, etc.
For severe tension pneumothorax or spontaneous hemopneumothorax, if not rescued in time, the patient may become unconscious or even die soon.
Treatment methods
【Traditional conservative treatment】—- relieve the symptoms, can’t cure, and easy to recur.
(1) Thoracentesis to extract the gas from the chest cavity.
(2) closed drainage of the chest, i.e., a cut in the chest wall and placement of a drainage tube to draw out the gas.
【Surgical radical treatment method】—- resection of large alveoli, effective radical treatment.
Traditional surgery —- open chest, traumatic, heavy pain and slow recovery.
Advanced technology —- thoracoscopic surgery, the “gold standard” for the treatment of spontaneous pneumothorax.
Advantages
1, less trauma, less pain. Only 3 small incisions of 1-1.5 cm under the axilla.
2, fast recovery after surgery. Generally, you can go to the ground on the second day after surgery, and the tube can be removed 3-4 days after surgery.
3, Good efficacy, little possibility of recurrence of pneumothorax.