Sarac Fatma, Yazici Mehmet, Kuzdan Mehmet Özgür
Department of Pediatric Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
Heliyon. 2024 Aug 22;10(17):e36732. doi: 10.1016/j.heliyon.2024.e36732. eCollection 2024 Sep 15.
The prevalence of spontaneous pneumothorax in children during adolescence is low, but not negligible. Treatment involves conservative management and surgery. The aim of this study was to review our patients treated with diagnoses of primary spontaneous pneumothorax and to describe our therapeutic approach, outcomes, and deficiencies.
Ninety (90) patients diagnosed with primary spontaneous pneumothorax and treated and followed-up in our clinic between June 2020 and December 2023 were included in the study. The research was performed as a retrospective file review. Trauma, secondary pneumothorax, and newborn pneumothorax were excluded.
Seventy six (76) patients were boys and 14 were girls, with a mean age of 16,23 years. Right pneumothorax was present in 44 patients, left pneumothorax in 41, and bilateral pneumothorax in 5. The 90 patients' initial treatment involved tube thoracostomy, and 36 individuals with prolonged and recurrent pneumothorax underwent video-assisted thoracoscopic surgery (VATS).
The success rate of apical wedge resection and mechanical pleurodesis with direct VATS in the treatment of prolonged and recurrent primary spontaneous pneumothorax in children is greater than 90 %. We think that, VATS is a successful, effective and safe treatment for spontaneous pneumothorax due to a significantly lower recurrence rate compared to chest tube insertion.
青少年期儿童自发性气胸的患病率较低，但并非可以忽略不计。治疗方法包括保守治疗和手术治疗。本研究的目的是回顾我们收治的原发性自发性气胸患者，并描述我们的治疗方法、治疗结果及不足之处。
本研究纳入了2020年6月至2023年12月期间在我们诊所诊断为原发性自发性气胸并接受治疗及随访的90例患者。研究采用回顾性病历审查的方式进行。排除创伤性、继发性气胸及新生儿气胸。
76例为男性患者，14例为女性患者，平均年龄为16.23岁。44例患者为右侧气胸，41例为左侧气胸，5例为双侧气胸。90例患者的初始治疗包括胸腔闭式引流术，36例气胸持续且复发的患者接受了电视辅助胸腔镜手术（VATS）。
在儿童持续性和复发性原发性自发性气胸的治疗中，直接VATS下的肺尖楔形切除术和机械性胸膜固定术的成功率超过90%。我们认为，与胸腔置管相比，VATS治疗自发性气胸的复发率显著降低，是一种成功、有效且安全的治疗方法。
