Poster Presentations: Wednesday, October 26, 2011 |

Video-Assisted Thoracic Surgery for Primary Spontaneous Hemopneumothorax: 20-Year Follow-up FREE TO VIEW

Calvin Ng, MD; Randolph Wong, MBChB; Eugene Yeung, MBBS; Micky Kwok, MBChB; Innes Wan, MBChB; Song Wan, MD; Anthony Yim, MD; Malcolm Underwood, MD
Author and Funding Information

Dept of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong

Chest. 2011;140(4_MeetingAbstracts):837A. doi:10.1378/chest.1106545
Text Size: A A A
Published online


PURPOSE: Video-assisted thoracic surgery (VATS) is increasingly being accepted as the approach of choice for a number of thoracic conditions. This study presents over two decades of experience from our institution on management of spontaneous hemopneumothorax (SHP), with particular reference to the use of VATS.

METHODS: Retrospective review between March 1988 and December 2010 with 53 patients with SHP, accounting for 4.1% of all patients treated for spontaneous pneumothorax. The clinical features, operative details and outcomes are analyzed.

RESULTS: Fifty-one SHP patients were male, with mean age of 23.6 years. Signs of significant hypovolemia occurred in 9 patients, 5 required blood transfusion. Mean initial blood drainage from tube thoracostomy was 473 ml (range 0-2100 mls). All SHP patients received surgery (5 thoracotomies, 48 VATS). Active bleeding was identified intra-operatively in 34 (64%) patients; 20 from torn apical vascular adhesions, 9 from torn vascular adhesions from multiple sites and 5 from vascular bleb. Postoperative complications after thoracotomy include 2 chest infections and 1 air leak, while VATS had 3 chest infections and 2 air leaks (p = 0.02). Mean postoperative hospital stay following VATS was 3.6 days and thoracotomy 7.5 days (p = 0.0018). There was 1 (1.9%) recurrence of pneumothorax following a previous VATS hemostasis pleurodesis for SHP. The mean follow-up is 94 months (range 4-249 months).

CONCLUSIONS: SHP is a potentially life threatening condition and a cause for patients presenting with unexplained signs of hypovolemia. Early surgery is a safe and effective approach to manage patients with SHP. Minimal invasive VATS can result in less postoperative complications and shorter hospital stay compared with open thoracotomy.

CLINICAL IMPLICATIONS: VATS should be the standard of care, and considered early in the management of SHP.

DISCLOSURE: The following authors have nothing to disclose: Calvin Ng, Randolph Wong, Eugene Yeung, Micky Kwok, Innes Wan, Song Wan, Anthony Yim, Malcolm Underwood

No Product/Research Disclosure Information

09:00 AM - 10:00 AM




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543