[Miniinvasive surgery in spontaneous pneumothorax--indications and surgical technique].
The aim of the spontaneous pneumothorax management is to recover permanent inflation of the affected lung to its original extent, and to prevent air leaks. The outcomes of miniinvasive surgeries, including videothoracoscopy and videoassissted procedures, are similar to those in classical procedures, while traumatization of the tissue and the patient's stress are minimized. The study gathered information from a number of literature data and provides an up-to- date overview of the subject of the spontaneous pneumothorax miniinvasive surgery, and, in particular, a detail analysis of particular indications, contraindications, surgical techniques and the technique's prospects. Currently, videothoracoscopy is considered a method of the first choice in the spontaneous pneumothorax relapses, and, in specific indications it is also accepted to manage the first attack of the disorder. A combination of the lung and pleural procedures is considered the most reliable. Peripheral lung resection using endostaplers appears the most suitable lung management method. Considering pleurodesis procedures, mechanical methods show superior results, the optimum procedure being partial apical pleurectomy in combination with pleuroabrasion in the remaining pleural cavity.
Vodicka
J
J
Chirurgická klinika Lékarské fakulty Univerzity Karlovy a Fakultní nemocnice v Plzni. vodicka@fnplzen.cz
Spidlen
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D000075202:Contraindications; D006801:Humans; D011030:Pneumothorax / Q000150:complications / Q000601:surgery*; D012008:Recurrence; D020775:Thoracic Surgery, Video-Assisted; D013906:Thoracoscopy