PNEUMOTHORAX
What is a pneumothorax?
Pneumothorax is the accumulation of air in the pleural space, resulting in collapse and collapse of the lungs. It is divided into two as spontaneous and acquired. It is divided into spontaneous primary and secondary pneumothorax. Primary spontaneous pneumothorax occurs as a result of bursting of bleb or bulla. Secondary spontaneous pneumothorax develops due to various diseases. These may be COPD, cystic fibrosis, various cancers (such as sarcoma), metastasis. Acquired pneumothorax, on the other hand, may develop due to iatrogenic (during biopsy, etc.) and traumas.
Primary spontaneous pneumothorax is more common especially in thin, tall young men. In these people, the most common cause is small tears in the lung tissue, which cannot fully develop in the upper part of the lung, caused by the explosion of the air cysts that develop just under the pleura, as a result of the increase in air pressure. Its incidence is 5-10 per 100,000. It is 6 times more common in men than women. There are approximately 13,000 pneumothorax cases per year in our country. Nearly 40% of the patients are in the 15-45 age group, and one third is male. Around 7000 injuries and accidental pneumothorax cases have been reported annually.
What Are the Symptoms of Pneumothorax?
Chest pain and shortness of breath, which start suddenly and can be very severe, are the most common symptoms. If the entire lung collapses, the patient may develop low blood pressure and shock. Patients may also experience coughing, rapid heart rate, and bruising on the lips. In a young patient presenting with these complaints, the diagnosis is made if collapse is detected in the chest X-ray.
The condition of having air in the thorax for any reason is called “pneumothorax“.
How Is Pneumothorax Treated?
The type of treatment is determined according to the degree of pneumothorax. Patients with a very small amount of air leakage are observed and oxygen therapy is started. If the collapse of the lung is excessive, attempts are made by the physician to expel the air from the cavity, tube drainage is applied. Although the leakage does not decrease despite all these interventions, the patient is treated with surgical intervention after a while. The applied surgical technique is resection of bullae with VATS through a single hole.
What are the Indications for Surgery in Pneumothorax?
– Air leakage after thorax tube lasting longer than 5-7 days
– Second time pneumothorax on the same side
– Previous contralateral pneumothorax
– First pneumothorax due to occupational necessity (such as diver, pilot)
– Synchronous (simultaneous) bilateral pneumothorax
– Patients who have undergone pneumonectomy (lung removed)
– Patients living far from the full-fledged center
The rate of recurrence (recurrence) of pneumothorax in patients who had a first pneumothorax is 20%. This rate is around 40% after Ci pneumothorax. Therefore, surgery is recommended after the second pneumothorax. The recurrence rate in operated patients is between 0.1-1%.