[Thoracoscopic surgery for spontaneous pneumothorax and its anesthetic considerations].
BACKGROUND
Incidence of spontaneous pneumothorax (SPT) is increasing recently. Video-assisted thoracic surgery (VATS) is, at present, accepted generally as a procedure of choice for surgical treatment of SPT. This study was designed to investigate whether pre-operative complications and epidural anesthesia contribute to post-operative outcome following VATS for SPT.


METHODS
From 1999 to 2002, 88 patients (78 men and 10 women, ranging in ages from 18 to 86, with an average age of 42 years) presented with SPT and received VATS at the Osaka Police Hospital. We evaluated the relationship between peri-operative risk factors and post-operative outcome after VATS for SPT.


RESULTS
Age and epidural analgesia contributed to post-operative pain (P=0.0268 and P=0.0165, respectively). Moreover, old age and long duration of surgery extended a hospitalization period (P=0.0002, r2=0.393 and P=0.0394, r2=0.224, respectively). In addition, old age contributes to post-operative pneumonia (P=0.0405). The patient with history of smoking had prolonged duration of surgery (P=0.0040) and oxygen supply after surgery (P=0.0312).


CONCLUSIONS
VATS for SPT is less invasive and contribute to short hospitalization. However, VATS also requires general anesthesia with one-lung ventilation. From our study, peri-operative careful management is necessary in a patient with old age and a habit of smoking.
Kita
Takashi
T
Department of Anesthesiology, Osaka Police Hospital, Osaka 543-8502.
Tajima
Keiko
K
Tanaka
Masaru
M
Nakagawa
Misato
M
Nakano
Sonoko
S
Sasaki
Shigeta
S
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery*; D011300:Preoperative Care; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome