Don’t intubate women with pneumothorax. Surgery with music and muse
KeywordsCatamenial pneumothorax, diaphragm endometriosis, spontaneous pneumothorax, non-intubated video-assisted thoracic surgery, video-assisted thoracoscopic surgery (VATS).
Background: Treatment of women with spontaneous pneumothorax is challenging and multidisciplinary. We performed a retrospective analysis of 10 females with spontaneous pneumothorax to determine the clinical features as well as the effects of treatment and recurrence rates. Our goal was to report that non-intubated video-assisted thoracic surgery is feasible and safe treatment of pneumothorax in women.Methods: A retrospective review was conducted of the clinical and pathologic data in all 10 patients undergoing treatment at our institution. 4 patients undervent treatment for catamenial pneumothorax. All 10 patients underwent surgical treatment.Results: The median age was 33 years. The laterality of the pneumothorax was right in 7, left in 3 patients. All patients underwent surgical treatment. Partial resection of the lung was performed in 10 patients and partial resection of the diaphragm with mesh diaphragm augmentation in four. Of these, both resections were performed in four patients. A pathological diagnosis of endometriosis was achieved in only four patients. The observation period was 6 months. No recurrences were observed. 8 patients were operated in the 1st, 1 in the 2nd, 1 in the 5th episode of pneumothorax. All patients were transferred to the ward 30 minutes and oral food intake was permitted 1 h after surgery.
Conclusions: non-intubated video-assisted thoracic surgery with mesh diaphragm augmentation, atypical lung resection and pleural abrasion could be considered a feasible, safe and effective method of treatment of catamenial pneumothorax. Prolonged follow-up and further clinical investigations are required to confirm the advantages of the proposed approach.
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