Background: Pneumothorax is defined as accumulation of air in the pleural space. Management of PSP conservatively have higher incidence of recurrence. Many studies now consider VATS is effective and safe procedure used for management and prevention of recurrence in the first attack PSP. Objectives: we aimed to evaluate the efficacy of using VATS in management of first attack PSP. The results were compared to conservative management to identify the best modality with lower recurrence rate. Patients and methods: This prospective randomized study was conducted in the department of Cardiothoracic Surgery, Menoufia University hospital included 60 patients with first attack PSP divided into two equal groups. Group A (VATS Group): 30 patients managed by VATS. Group B (conservative group): 30 patients managed conservatively. Results: All participants were male, and both groups had similar mean ages (Group A: 23.97 ± 3.66 years; Group B: 23.60 ± 3.75 years) and BMI values (Group A: 19.71 ± 1.18; Group B: 19.77 ± 1.33). Significant differences were observed in clinical outcomes. Group A (VATS) had a shorter length of hospital stay (mean 3.07 ± 0.78 days vs. 6.63 ± 1.07 days; p ≤ 0.001) and shorter chest tube duration (mean 2.07 ± 0.78 days vs. 5.87 ± 1.14 days; p ≤ 0.001) compared to Group B (Conservative). Recurrence rates were also lower in Group A (6.7% vs. 33.3%; p = 0.010). Conclusion: VATS is effective and safe method for management first attack PSP with significant reduction in recurrence rate and length of hospital stay.
Abdelmotaleb et al. (Tue,) studied this question.