Justifying video-assisted thoracic surgery for spontaneous hemopneumothorax

Yi Cheng Wu, Ming Shian Lu, Chi Hsiao Yeh, Yun Hen Liu, Ming Ju Hsieh, Hung I. Lu, Hui Ping Liu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

35 Scopus citations

Abstract

Study objectives: Video-assisted thoracic surgery (VATS) has gained a prominent role in routine thoracic surgery practice. This study discusses the clinical aspects and utility of VATS in spontaneous hemopneumothorax (SHP). Patients: Of 363 spontaneous pneumothorax (SP) cases, 24 patients presented with SHP (6.6%). The clinical features, surgical indications, emergency VATS technique, and patient outcomes are discussed. Results: All 24 patients were male (mean age, 25.3 years). Eleven patients were in hypovolemic shock, and their hemoglobin levels ranged from 6.7 to 12.7 g/dL; therefore, they received fluid resuscitation and blood transfusion. The amount of blood drained through the chest tube varied from 200 to 3,500 mL. Emergency VATS revealed that 5 cases were simple hemothoraces and 19 cases were associated with pneumothorax. The cause of bleeding was identified by thoracoscopy, as from an aberrant vessel (n = 11), torn parietal pleura (n = 4), ruptured vascularized bullae (n = 2), and lung parenchyma (n = 1). Six patients had no evidence of an obvious bleeding site. Bullous lesions were at the apex of the upper lobe in 14 patients, and multiple lobar involvement was seen in 2 patients. All the bullae were resected with endoscopic stapler in eight patients and ligated with a homemade endoloop in eight patients. The mean operation time was 42 min. The mean chest tube removal time was 3.5 days after insertion, and mean postoperative stay was 4.5 days. There is no recurrence of SHP or SP during the follow-up period. Conclusion: SHP complicated by severe bleeding presents a potentially grave emergency. VATS may be considered as feasible treatment for patients with SHP.

Original languageEnglish
Pages (from-to)1844-1847
Number of pages4
JournalChest
Volume122
Issue number5
DOIs
StatePublished - 2002
Externally publishedYes

Keywords

  • Endoloop
  • Spontaneous hemopneumothorax
  • Video-assisted thoracic surgery

Fingerprint

Dive into the research topics of 'Justifying video-assisted thoracic surgery for spontaneous hemopneumothorax'. Together they form a unique fingerprint.

Cite this