A different approach in primary spontaneous pneumothorax surgery: Lateral pleurectomy technique and results

Abstract

Background: Primary Spontaneous Pneumothorax is a disease with a frequent recurrence rate. The uniportal videothoracoscopic surgery approach is the standard treatment for air leak and recurrence prevention. In common practice, apical pleurectomy is used after apical wedge resection. Our study aims to examine the results, especially the recurrence rate, of the lateral pleurectomy and apical pleural abrasion combination technique applied as an alternative to this technique.Methods: A total of 50 patients who underwent uniportal videothoracoscopic surgery for primary spontaneous pneumothorax between November 2018 and May 2021 were included in the study. The follow-up period for recurrence of the patients was 12-42 months. Age, gender, pneumothorax side, operation indication, Body Mass Index, smoking history, incision length and location, air leakage and tube thoracostomy duration, Verbal Numeric Pain Scores, post-operative length of hospital stay, complications, and recurrence data were recorded.Results: Of the 50 patients, 44 (88%) were male, and 6 (12%) were female, with a mean age of 22.3±5.9 years. Surgery was performed from the existing drain site in 32 (64%) cases and the former drain scar in 11 (22%) cases. The mean duration of tube thoracostomy was 2.7±0.97 days, and the mean length of hospital stay was 3.6±0.89 days. Complications developed in 2 (4%) cases, and recurrence was observed in 2 (4%) cases.Conclusions: Lateral pleurectomy with the apical pleural abrasion technique is easy to apply and reduces the possibility of undesired hemorrhagic drainage. We believe that the lateral pleurectomy technique is safe, easily applicable, and less risky in terms of hemorrhage.