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  • Title: Video-assisted thoracoscopy for spontaneous pneumothorax after pneumonectomy.
    Author: Orki A, Tasci AE, Meydan B, Kutlu CA.
    Journal: Heart Lung Circ; 2009 Aug; 18(4):299-301. PubMed ID: 18514025.
    Abstract:
    In this paper, we present 3 patients who had previously undergone pneumonectomy and then presented with a spontaneous pneumothorax. The indication for pneumonectomy was tuberculosis and NSCLC in 2 and 1 patient, respectively. The interval between the surgery and development of pneumothorax was 2, 4, and 11 years. On admission, 2 of the 3 patients were in extreme respiratory distress requiring urgent chest tube insertion. In all patients we undertook elective video-assisted thoracoscopy with complete preparation for cardiopulmonary support on the side. Bullectomy and/or diathermy ablation for apical bullae and blebs were performed concomitantly with total parietal pleurectomy. The postoperative course was uneventful in the patients, and they remain on routine follow-up for up to 6-12 months without any complaints. Our experience suggests that emphysematous changes in the remaining lung should be carefully inspected during long-term follow-up after pneumonectomy. Video-assisted thoracoscopic (VAT) pleurectomy appears to be a good option for the management of spontaneous pneumothorax only if it is performed by a dedicated multidisciplinary team with various cardiopulmonary support facilities on the side.
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