ABSTRACT
Objectives: To evaluate the efficacy of the chest tube drainage [CTD] and the needle aspiration [NA] in the treatment of primary Spontaneous pneumothorax [SP]
Methods: In a randomized controlled trial, seventy patients suffering SP were divided equally into two subgroups, as follows: [A] CTD and [B] NA. The immediate and one-week rate of the treatments was the primary endpoints. Postoperative complications, length of hospital stay and incidence of pneumothorax recurrence during one-year follow up were also recorded
Results: The immediate success of treatment was 68.5% and 54.2% of patients in CTD and NA groups, respectively that showed no significant difference between study groups [P: 0.16]. The complete lung expansion after one week observed in 32 [91.4%] of NA group and 33 [94.2%] patients in CTD group [P: 0.5]. Pneumothorax recurrence was detected in 13 patients [4 in NA and 9 in CTD group] [P: 0.11]. Mean pain intensity was significantly lower in the NA group at the first hour after the procedure, the first postoperative day and the first week after the intervention [P< 0.001]
Conclusion: Needle aspiration [NA] can be applied as a first step treatment in patients with primary SP, considering its advantages
ABSTRACT
Objective: To assess the efficacy of intercostal nerve protection by intercostal muscle [ICM] flap in post-thoracotomy pain improvement compared to intracostal suturing
Methods: In a randomized controlled trial, ninety-four patients undergoing posterolateral thoracotomy surgery were divided into two subgroups. Intracostal sutures in isolation and in combination with ICM flap techniques were used for thoracotomy closure in both groups. Numeric Pain Scale and Visual Pain Scale as pain scores were assessed on the first, second, third, fourth, fifth, sixth and seventh postoperative days and follow-up visits during the 2[nd] week, 1[st], 2[nd], 4[th] and 6[th] months after thoracotomy
Results: Out of 94 patients, 58 were male and 36 were females. While the mean age of patients in intracostal group was 45.3 +/- 17.6 years, it was 47.4 +/- 16.1 years in intracostal plus ICM flap group. The mean operation time for the first group was 191.0 +/- 74.7 minutes, while it was 219.3 +/- 68.8 minutes in the second [p>0.05]. Numeric rating score and visual pain scale did not demonstrate any significant difference in pain severity on postoperative days and follow-up visits between both groups [p>0.05]. Although the trend of pain reduction was significant in each group [p<0.001], the difference was not statistically significant [p>0.001]
Conclusion: Intracostal sutures in combination with muscle flap did not reduce postoperative pain in thoracotomy compared with intracostal sutures alone in thoracotomy closure