What is pneumothorax and how is it treated?
There is no air in the rib cage under normal conditions. The presence of air in the chest cavity for any reason is called pneumothorax.
- Deflating occurs in the lung when air collects in the chest cavity.
- Also known as lung explosion.
You can read the questions asked by the patients and the answers we gave at the bottom of the page, and you can use the question section below for your questions.
WHAT CAUSES PNEUMOTHORAX?
Causes of pneumorax are divided into 3
1. Spontaneous (spontaneous) pneumothorax
- Although it is said to occur spontaneously, this type of pneumothorax is a type of pneumothorax that occurs as a result of the explosion of small bubbles (blebs) in the lung that are not seen on normal chest radiographs.
- This type of pneumothorax is the most common type of pneumothorax.
2. (secondary) pneumothorax due to a disease
Pneumothoraxes occur as a result of damage caused by diseases such as large balloons, emphysema, pneumonia or tuberculosis present in the lungs.
3. (iatrogenic) pneumothorax resulting from a medical intervention
In cases such as needle biopsy from the lung, placement of a catheter, or after an abdominal surgery, this type of pneumothorax can be caused by air collection in the chest cavity.
What are the Symptoms of Pneumothorax?
Symptoms are severe back and chest pain, cough and shortness of breath.
In such complaints of sudden onset, pneumothorax is suspected and diagnosed by chest X-ray.
In the case of pressure pneumothorax, these complaints may become more and more serious. In case of slight accumulation of air, the symptoms may subside spontaneously over time. However, waiting for it to pass is risky. It should be under the supervision of a doctor.
Who Is Pneumothorax More Common?
Spontaneous (spontaneous) pneumothorax is more common in tall, lean men. It is less in women than in men. For detailed information on this subject, please click.
Pneumothorax Treatment
- The degree of the patient’s complaint (such as cough, shortness of breath, back and chest pains),
- Amount of pneumothorax,
- whether the patient has other diseases (heart and lung diseases),
- Related to situations such as whether she had a previous pneumothorax.
What are the Pneumothorax Surgery Methods?
Accordingly, in some pneumothorax cases, it may be possible to only monitor the patient without any action, or it may be necessary to remove the disease by drawing the air in the chest cavity with an injector (aspiration), inserting a drain (chest tube) or operating with a closed method.
The most commonly used method is to evacuate the air with the help of a thin silicone drain under sedation anesthesia and without the patient feeling any pain.
When Is Pneumothorax Surgery Necessary?
If one of the following conditions exists:
- Second pneumothorax,
- Pneumothorax occurring together on the right and left,
- Seeing large balloon sacs in the lung,
- Conditions that do not heal in 5 days despite a drain,
- Occupational reasons (such as pilots),
- Pneumothorax occurring for the first time in those living far from the health institution.
What do International Resources for Pneumothorax Treatment Recommend?
Both British (BTS) and American Thoracic Associations (ACCP) have prepared guidelines on this subject.
You can access the guide prepared by the British Thoracic Diseases Society (BRITISH THORACIC SOCITEY) from the links below
BTS: http://thorax.bmj.com/content/58/suppl_2/ii39.full
What are the Pneumothorax Surgery Methods?
Installation of chest tube (drain)
Under sedation anesthesia, a silicone drain with an average thickness of one pen is advanced into the chest cavity between the 7th and 8th ribs on the side of the disease. This drain is connected to a sterile unit consisting of a bottle with water at the bottom. When the air in the chest cavity is emptied, the deflated lung is restored.
Open surgery
The open method is rarely preferred nowadays. It is opened with the help of a retractor between the 3rd and 4th ribs with a 7-8 cm long incision made under the armpit. The air sacs in the lung are removed with a special method. The upper part of the outer membrane of the lung, called the pleura, can be removed (pleurectomy) or a reaction is created here, allowing the lung to adhere (pleurodesis).
Thus, the collapse of the lung and the collection of air in the chest cavity are prevented. At the end of the operation, a drain is placed in the chest cavity and the layers are closed in the anatomical plane. The drain is removed 1 or 2 days after the surgery.
Closed – Endoscopic (VATS) Pneumothorax Surgery
This is the most used method. In this method, the camera is advanced into the chest cavity through a single incision of 2 cm (uniportal method), and the procedures specified in the open method are performed.
It is the least harmful operation method for the patient.
This method called Single Port VATS should be preferred instead of open surgery.
After this method, the pain is less, the surgical incision (2cm) is much smaller, and the patient’s return to normal life is much faster.
What are the Risks of Pneumothorax Surgery?
There may be risks such as air leakage from the lung, bleeding, infection and recurrence of the disease. The surgeon takes the necessary precautions according to these situations and minimizes the risks.
The incidence of these complications after closed surgery for pneumothorax is between 2-10%.
How Many Days Should I Stay in the Hospital for Pneumothorax Surgery?
On average; 3 days in case of only drain insertion, 4-5 days after open surgeries and closed – Hospitalization for 2-3 days is required after endoscopic surgeries.
What are the recurrence rates of pneumothorax?
- In people who have had a pneumothorax once, the probability of recurrence after a while is 20% if it is treated only by inserting a chest tube (drain).
- In people who have had two pneumothorax and have been treated with only a drain, the probability of this happening for the third time is 50%.
- The probability of recurrence of pneumothorax in people who have undergone surgery is between 3-5%.
In the thorax computed tomography of a person who has had a pneumothorax once, it should be investigated whether there are bubbles that cause this disease. In case of bubbles, the operation with VATS method will prevent recurrences.