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Amaç: Çalışmamızdaki amacımız çocukluk yaş grubunda oldukça nadir görülen primer spontan pnömotoraks (PSP) ile ilgili, iki merkezin takip ve tedavi deneyimlerini literatür ışığında sunmaktır. Yöntem: Çalışmada, 1 Agustos 2016 ve 1 Agustos 2021 tarihleri arasında iki merkeze başvuran PSP li hastaların yaş, cinsiyet, boy, vücut kitle indeksi (VKİ), başvuru şikayeti, radyolojik bulguları, pnömotoraks yüzdeleri, takip ve tedavi kayıtları geriye dönük olarak incelendi. Bulgular: Çalışmaya 23 hasta dahil edildi. Hastaların 21’ i (%91.3) erkek, 2‘si (%8.7) kızdı ve yaş ortalaması 16.4±0.6 yıldı. Boy ortalaması 180.8±7.9 cm, VKİ’si 21.1±2.6 kg/m2 idi. Olguların başlıca şikayetleri göğüs ağrısı, solunum sıkıntısı, öksürük ve omuz ağrısıydı. Tüm hastalara başvuru anında postero anterior akciğer grafisi çekildi. Persistan hava kaçağı olan, rekürrens gelişen ve akciğer grafisiyle tanıdan emin olunamayan 9 olguya (% 40.9) toraks bilgisayarlı tomografi (BT) çekildi. Olguların ilk başvurularında pnömotoraks yüzdesi %15 in altında olan 5 hastaya konservatif tedavi ( nazal oksijen 2-4 lt/dk), diğer 18 hastaya tüp torakostomi uygulandı. Çalışmamızda 8 (% 36.3) olguya video yardımlı toraks cerrahisi (VATS) yapıldı. Çalışmamıza dahil edilen 4 (%18.1) olguda rekürrens gelişmişti. Sonuç: Çocukluk çağı PSP’ lerinde tanı, tedavi ve takip sürecinde standart bir yaklaşım yoktur. Standart yaklaşımın sağlanması amacıyla yeni ve prospektif çalışmalara ihtiyaç olduğunu düşünmekteyiz. Çocukluk çağı PSP tedavisinde VATS’ ın etkili bir cerrahi metot olduğunu ve BT’ nin yararlı ve gerektiğinde başvurulabilecek bir tanı aracı olabileceğini düşünmekteyiz.
Purpose: Our aim in the study is to present the tracking and therapeutic experiences of the two centers related to primary spontaneous pneumotorax (PSP), which is quite rare in the childhood age group in the light of literature. Method: In the study, between 1 August 2016 and 1 August 2021, the age, gender, size, body mass index (BMI), application complaint, radiological findings, pnömotoraks percentages, tracking and treatment records of patients with PSP were reviewed backward. 23 patients were involved in the study. 21 of the patients (91.3%) were male, 2 (8.7%) were angry and the average age was 16.4±0.6 years. The size average was 180.8±7.9 cm, the VKI was 21.1±2.6 kg/m2. The main complaints of the cases were chest pain, breathing failure, coughing and shoulder pain. All patients were immediately removed from the postero anterior lungs graph. The persistent air escape, recurrent development and uncertain diagnosis with lung graphics, 9 incidents (40.9%) were drawn to the thorax computer tomography (BT). In the first applications of the cases, 5 patients with a pnömotoraks percentage below 15% were treated with conservative therapy (nose oxygen 2-4 lt/min), the other 18 patients were subjected to tube toracostomy. In our study, 8 (36.3% of the incidents were performed with video-assisted toral surgery (VATS). 4 (18.1) cases involved in our study were recurrently developed. There is no standard approach to the process of diagnosis, treatment and follow-up in childhood PSPs. We consider the need for new and prospective work in order to provide a standard approach. In childhood PSP treatment, we consider that VATS is an effective surgical method and that IT can be a useful and applicable diagnostic tool.
Objective: To present the follow-up and treatment experiences of two centers regarding primary spontaneous pneumothorax (PSP), which is rare in childhood, in the light of the literature. Methods: Age, gender, height, body mass index (BMI), complaint, radiological findings, pneumothorax percentages, follow-up and treatment records of patients with PSP who admited to two centers between 1 August 2016 and 1 August 2021 were retrospectively analyzed. Results: A total of 23 patients were included in the study. Twenty-one (91.3%) patients were male, 2 (8.7%) were female, and the mean age was 16.4±0.6 years. Mean height was 180.8±7.9 cm, and BMI was 21.1±2.6 kg/m2. The main complaints were chest pain, respiratory distress, cough and shoulder pain. Chest X-ray was taken in all patients. Computed tomography ( CT) was performed in 9 patients (40.9%) who had persistent air leaks, developed recurrence and whose diagnosis could not be determined by X-ray. Conservative treatment (nasal oxygen 2-4 lt/min) was performed to 5 patients with pneumothorax percentage below 15% at the first admission, and tube thoracostomy in 18 patients. Video-assisted thoracic surgery (VATS) was performed in 8 (36.3%) cases. Recurrence developed in 4 (18.1%) cases. Conclusion: There is no standard approach in the diagnosis, treatment and follow-up process of childhood PSP. We think that new and prospective studies are needed in order to provide a standard approach on this issue. We think that VATS is an effective surgical method in the treatment. In addition, we considered that CT can be a useful diagnostic tool in management of PSP.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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