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International Journal of Respiratory Medicine
|
Volume 3
LUNG CANCER AND COPD
5
th
International Congress on
J u n e 2 5 - 2 6 , 2 0 1 8 | A m s t e r d a m , N e t h e r l a n d s
Esther Ern-Hwei Chan et al., Int J Respir Med 2018, Volume 3
THE USE OF REINFORCED SURGICAL
STAPLER RELOADS IN SECONDARY
SPONTANEOUS PNEUMOTHORAX
Esther Ern-Hwei Chan, Aneez Dokev Basheer Ahmed
and
Atasha Asmat
Tan Tock Seng Hospital, Singapore
Introduction:
Secondary spontaneous pneumothorax (SSP) commonly afflicts
patients with chronic obstructive pulmonary disease (COPD). Indications for
surgery remain unclear as these patients often have other co-morbidities
which increase risk of surgery as well as concerns of prolonged air-leak.
The use of reinforced surgical stapler reloads (RSSR) is one of the methods
proposed to decrease incidence of air-leak. We report outcomes following the
use of RSSR in SSP patients with COPD.
Methods:
All COPD patients with SSP who underwent surgical management
with the use of RSSR in a single-institution from May 2015 to May 2017 were
included. Demographic and clinical data were collected retrospectively.
Results:
28 patients with a mean age of 69 (51-93) years were included. All
patients were male and smokers with an average smoking pack-years of
45.6 (20-100). One patient had co-existing interstitial lung disease and six
had previous or current lung tuberculosis. All patients had intra-operative
pleurodesis, either talc (50%), abrasion (7%) or both (43%). Median immediate
air-leak measured by a digital-drainage-system post-operatively was 300ml/
min (0-3300). Median duration chest tube
in-situ
was 7 (2-36) days, with 10
(35.7%) patients discharged home with chest tube
in-situ
. Fifteen (53.6%)
patients had prolonged air-leak (more than five-days). Post-operative
complications include 6 (21.4%) patients with pneumonia, 2 (7.1%) requiring
ventilator support for more than 48-hours and 2 (7.1%) requiring reintubation.
There were four 30-day mortalities; in all the cause-of-death was pneumonia.
There was an additional mortality at 90-days due to pneumonia.
Conclusion:
In our study, the use of RSSR does not decrease the incidence of
prolonged air leak in COPD patients with SSP.
Esther Ern-Hwei Chan is graduated with an MA
in Genetics from University of Cambridge and
MBBS from Imperial College, London in 2014.
She obtained her membership to the Royal Col-
lege of Surgeons, England (MRCS) in 2015. She
is currently working as a junior doctor in Singa-
pore. She has published more than five papers
in reputed journals and has presented posters
and oral presentations at multiple conferences
both locally and internationally.
esther.e.chan@gmail.comBIOGRAPHY