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Thoracoscopic treatment of primary spontaneous pneumothorax in children – report of three cases Torakoskopowe leczenie pierwotnej samoistnej odmy opłucnowej u dzieci – opis trzech przypadków

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Author(s): Janusz Jabłoński | Paweł Polityło | Małgorzata Lewandowska | Ewa Andrzejewska

Journal: Przegląd Pediatryczny
ISSN 0137-723X

Volume: 41;
Issue: 2;
Start page: 82;
Date: 2011;
Original page

Keywords: primary spontaneous pneumothorax | chest tube drainage | thoracoscopy | treatment

ABSTRACT
Pneumothorax is defined as air accumulated in the pleural cavity. It can be categorized as spontaneous, traumatic or iatrogenic. Spontaneous pneumothorax can be further classified into primary or secondary. Primary spontaneous pneumothorax usually is caused by rupture of a subpleural bleb or bulla. The current treatment options for pneumothorax include observation, needle aspiration, tube thoracostomy, thoracotomy or thoracoscopy. There are few reports on treatment of SP in the pediatric population. Between 2007 and 2010 in the Department of Pediatric Surgery and Oncology Medical University of Łodź 3 patients (2 boys and 1 girl) underwent thoracoscopy for primary spontaneous pneumothorax. The indications for thoracoscopy were failure of lung expansion after chest tube placement, persistent air leak (>7 days) and contralateral pneumothorax. Patients’ age was 15, 16 and 17 years, respectively. In all cases resection of a bulla was performed. We did not observe any ipsilateral recurrences. One patient had recurrence of pneumothorax on the opposite side. The authors underline that thoracoscopy is a safe and effective method in children with primary spontaneous pneumothorax. High recurrence rates after treatment with chest tube drainage support early thoracoscopy.
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