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CC BY 4.0 · Surg J (N Y) 2023; 09(04): e149-e155
DOI: 10.1055/s-0043-1770954
Original Article

Which Role for Muscle-Sparing Posterolateral Thoracotomy in the Treatment of Spontaneous Pneumothorax?

Ibrahim Issoufou
1   Department of Thoracic Surgery, Teaching Hospital Hassan II, Fez, Morocco
,
Rabiou Sani
1   Department of Thoracic Surgery, Teaching Hospital Hassan II, Fez, Morocco
,
Daouda Amadou
2   Department of Cardiovascular Surgery, Teaching Hospital Hassan II, Fez, Morocco
,
Kadre Alio
3   Department of Stomatology and Maxillofacial Surgery, Hôpital Général de Référence, Niamey, Niger
4   Department of Surgery and Surgical Specialities, Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger
,
Kaled Adamou-Nouhou
2   Department of Cardiovascular Surgery, Teaching Hospital Hassan II, Fez, Morocco
,
Marouane Lakranbi
1   Department of Thoracic Surgery, Teaching Hospital Hassan II, Fez, Morocco
5   Department of Surgery, Faculty of Medicine and Pharmacy, University Sidi Mohamed Ben Adellah, Fez, Morocco
,
Rachid Sani
4   Department of Surgery and Surgical Specialities, Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger
6   Department of General Surgery, National Hospital of Niamey, Niamey, Niger
,
Yassine Ouadnouni
1   Department of Thoracic Surgery, Teaching Hospital Hassan II, Fez, Morocco
5   Department of Surgery, Faculty of Medicine and Pharmacy, University Sidi Mohamed Ben Adellah, Fez, Morocco
,
Habibou Abarchi
4   Department of Surgery and Surgical Specialities, Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger
7   Department of Pediatric Surgery, Hospital Amirou Boubacar Diallo, Niamey, Niger
,
Mohamed Smahi
1   Department of Thoracic Surgery, Teaching Hospital Hassan II, Fez, Morocco
5   Department of Surgery, Faculty of Medicine and Pharmacy, University Sidi Mohamed Ben Adellah, Fez, Morocco
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Abstract

Objective This study aims to show the place of muscle-sparing posterolateral thoracotomy in the treatment of spontaneous pneumothorax.

Methods It was a single-center study performed in the Department of Thoracic Surgery of Teaching hospital Hassan II of Fez for 8 years. We adopted the nosological definition, which classifies spontaneous pneumothorax into three categories. We included patients over 15 years of age with primary or secondary spontaneous pneumothorax operated by posterolateral thoracotomy without muscle section, and we analyzed the specific indications of this approach. It included 49 patients with primary or secondary spontaneous pneumothorax, operated by muscle-sparing posterolateral thoracotomy. Data were collected from regularly updated computer files of patients, entered by Excel 2013, and analyzed using SPSS.20 software. These data are: epidemiological, clinical, radiological, surgical exploration, surgical procedure, the result of the surgery and the evolution.

Results The average age was 42 years. Smoking was found in 61% of cases and pulmonary tuberculosis in 10% of cases. Thoracic computed tomography (CT) showed bullae and blebs in 31% of cases, pleural adhesions and pachypleuritis in 50% of cases, and hydropneumothorax with pachypleuritis in 37% of cases. There is a statistical correlation between pleuropulmonary decortication and pachypleuritis (p = 0.002) or hydropneumothorax (p = 0.001) on CT. Bullae and blebs resection was performed in 53% of cases and pleuropulmonary decortication in 63% of cases. A right pleuropneumonectomy was performed in one case. The follow-up was uneventful in 82% of cases.

Conclusion Muscle-sparing posterolateral thoracotomy remains the best approach and leads to good results.

Keywords

pneumothorax - spontaneous pneumothorax - thoracocentesis - pleural tuberculosis - thoracotomy


Publikationsverlauf

Eingereicht: 28. Juli 2021

Angenommen: 26. Mai 2023

Artikel online veröffentlicht:
28. Dezember 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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