Al-Mourgi Majed, Alshehri Fahad
Int J Health Sci (Qassim). 2015 Oct;9(4):428-32.
Recent studies have shown that video-assisted thoracoscopy (VATS) is safe and beneficial as first time treatment for patients presenting with primary spontaneous pneumothorax (PSP). In this study we will compare the outcome of patients presenting with first time PSP treated by VATS with those treated conservatively.
This was a prospective double-blind, randomized clinical trial conducted at our hospital, Forty one patients, presented to the hospital with first attack PSP from January 2010 to January 2013, were randomized to be treated by chest tube drainage (conservative group, group 1) or by primary video-assisted thoracoscopy (VATS group, group 2). Outcomes were; duration of intercostal tube drainage, mean hospital stay, and recurrence rates of pneumothorax during the period of follow up.
There was no significant difference in both groups regarding demographic data. The mean durations of removal of intercostal tube and hospital stay were significantly higher in conservative group than in VATS group. The recurrence rate in conservative group was 40.9% versus 0% in VATS group (highly significant).
Initial VATS is considered an efficient treatment modality for PSP as it has a shorter hospital stay and lower recurrence than conservative treatment, which if occurs, requires re-hospitalization with needs for VATS or surgery.
近期研究表明，电视辅助胸腔镜手术（VATS）作为首次治疗原发性自发性气胸（PSP）患者的方法是安全且有益的。在本研究中，我们将比较接受VATS首次治疗的PSP患者与接受保守治疗的患者的治疗结果。
这是一项在我院进行的前瞻性双盲随机临床试验。2010年1月至2013年1月期间，41例因首次发作PSP入院的患者被随机分为接受胸腔闭式引流治疗（保守组，第1组）或初次电视辅助胸腔镜手术治疗（VATS组，第2组）。观察指标包括：肋间引流管留置时间、平均住院时间以及随访期间气胸复发率。
两组患者的人口统计学数据无显著差异。保守组肋间引流管拔除时间和住院时间的平均值显著高于VATS组。保守组的复发率为40.9%，而VATS组为0%（差异极显著）。
初次VATS被认为是治疗PSP的一种有效治疗方式，因为与保守治疗相比，它住院时间更短且复发率更低，保守治疗若出现复发则需要再次住院并可能需要进行VATS或手术。
