Abstract
Background: Video-assisted thoracoscopic surgery (VATS) with partial pleurectomy is an established treatment for primary spontaneous pneumothorax (PSP). However, postoperative pulmonary function and health-related quality of life (HR-QoL) after VATS–bullectomy with partial pleurectomy (VBPP) have not been elucidated. Methods: Eligible patients were assessed for HR-QoL using the Short-Form 36 (SF-36) health survey. Pulmonary function (PF) was evaluated by spirometry. We compared the results of the VBPP cohort with the German national norms, and with a similar cohort of patients successfully treated by chest tube (CT) only. Results: A total of 25 VBPP patients completed the SF-36 health survey, of whom 15 presented for PF assessment. Between the VBPP and CT groups, the mean forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio were not statistically significantly different. However, in both groups, FVC, FEV1, and FEV1/FVC were above the lower limit of normal (LLN), suggesting no restrictive or obstructive patterns. Compared with the sex- and age-matched normal German population, patients who underwent VBPP displayed a similar physical component summary score and a significantly decreased mental component summary score. Interestingly, comparison of the SF-36 domains between the VBPP and CT groups showed no statistical difference. Conclusion: VBPP is a suitable surgical treatment for PSP, with no apparent adverse impacts on pulmonary or physical function. However, psychological distress and measures to counteract its impact should be considered.
Highlights
According to the German S3 guidelines, primary spontaneous pneumothorax (PSP) describes the presence of air within the pleural space of patients under 45 years of age, without preceding trauma or underlying pulmonary disease [1]
Weight, height, and body mass index (BMI) were re-evaluated at presentation in our outpatient clinic
We found no significant differences in forced vital capacity (FVC) or FEV1, nor in the FEV1/FVC ratio, between the VATS–bullectomy with partial pleurectomy (VBPP) and chest tube (CT) groups
Summary
According to the German S3 guidelines, primary spontaneous pneumothorax (PSP) describes the presence of air within the pleural space of patients under 45 years of age, without preceding trauma or underlying pulmonary disease [1]. Studies that evaluate preoperative lung function of patients at first presentation of PSP are lacking. This is most likely due to the acute symptoms at presentation, which might be life-threatening and may require emergency treatment. Reports that elucidate the impact of VATS, in combination with bullectomy and pleurectomy on pulmonary function after treatment are lacking. It is still unknown whether wedge resection of blebs or pleurectomy to ensure tight adhesion of the affected lung to the thoracic wall cause restrictive pulmonary function impairment. Psychological distress and measures to counteract its impact should be considered
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