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<p>Spontaneous pneumothorax represents a frequent emergency in thoracic surgery, with the rupture of pulmonary bullae being the primary cause. Thoracoscopic bullectomy combined with parietal pleural fixation has proven to be an effective approach for lesion removal and recurrence prevention. Nevertheless, there remains no consensus regarding which parietal pleural fixation method should be employed during the procedure. This study aims to compare the differences between parietal pleurectomy and pleural abrasion in terms of perioperative indicators, postoperative complications, and postoperative recurrence rates. A retrospective analysis was performed on 204 patients with spontaneous pneumothorax admitted to our center between January 2023 and December 2024. Based on the surgical procedures, patients were categorized into an observation group (<i>n</i> = 90) who underwent parietal pleurectomy and a control group (<i>n</i> = 114) who underwent pleural abrasion. Perioperative indicators, postoperative complications, and recurrence rates were systematically collected and analyzed for both groups. The control group exhibited significantly better outcomes than the observation group in terms of operation time, intraoperative blood loss, postoperative VAS score, postoperative drainage duration, total drainage volume, and length of hospital stay (<i>P</i> &lt; 0.05). However, the recurrence rate at 3&#xa0;months post-surgery was significantly lower in the observation group compared to the control group (<i>P</i> = 0.027). Additionally, no significant difference was observed in the incidence of postoperative complications between the two groups (<i>P</i> = 0.885). For patients with spontaneous pneumothorax combined with pulmonary bullae, parietal pleurectomy inevitably increases the perioperative burden on patients and prolongs their hospital stay; however, it effectively reduces the risk of postoperative recurrence. The safety profiles of both surgical approaches are comparable. Clinically, the most appropriate plan should be chosen based on individual patient characteristics.</p>

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A comparative study on the efficacy and safety of thoracoscopic bullectomy combined with different pleurodesis for the treatment of spontaneous pneumothorax

  • 期刊论文

  • 发表日期：

    2025年8月4日

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  • Kai Yang,
  • Yongzhi Liu,
  • Qi Wang,
  • Xv Tang,
  • Zhibo Ye,
  • Dacheng Jin,
  • Yun-jiu Gou

摘要

Spontaneous pneumothorax represents a frequent emergency in thoracic surgery, with the rupture of pulmonary bullae being the primary cause. Thoracoscopic bullectomy combined with parietal pleural fixation has proven to be an effective approach for lesion removal and recurrence prevention. Nevertheless, there remains no consensus regarding which parietal pleural fixation method should be employed during the procedure. This study aims to compare the differences between parietal pleurectomy and pleural abrasion in terms of perioperative indicators, postoperative complications, and postoperative recurrence rates. A retrospective analysis was performed on 204 patients with spontaneous pneumothorax admitted to our center between January 2023 and December 2024. Based on the surgical procedures, patients were categorized into an observation group (n = 90) who underwent parietal pleurectomy and a control group (n = 114) who underwent pleural abrasion. Perioperative indicators, postoperative complications, and recurrence rates were systematically collected and analyzed for both groups. The control group exhibited significantly better outcomes than the observation group in terms of operation time, intraoperative blood loss, postoperative VAS score, postoperative drainage duration, total drainage volume, and length of hospital stay (P < 0.05). However, the recurrence rate at 3 months post-surgery was significantly lower in the observation group compared to the control group (P = 0.027). Additionally, no significant difference was observed in the incidence of postoperative complications between the two groups (P = 0.885). For patients with spontaneous pneumothorax combined with pulmonary bullae, parietal pleurectomy inevitably increases the perioperative burden on patients and prolongs their hospital stay; however, it effectively reduces the risk of postoperative recurrence. The safety profiles of both surgical approaches are comparable. Clinically, the most appropriate plan should be chosen based on individual patient characteristics.