Article ; Online: VATS in complicated COVID-19 patients: case series.
2022 Volume 75, Issue 3, Page(s) 717–722
Abstract: Common complications of coronavirus disease 2019 (COVID-19) related ARDS and ventilation are barotrauma-induced pneumothorax, pneumatocele and/or empyema. We analysed indications and results of video-assisted thoracoscopic surgery (VATS) in complicated ... ...
| Abstract | Common complications of coronavirus disease 2019 (COVID-19) related ARDS and ventilation are barotrauma-induced pneumothorax, pneumatocele and/or empyema. We analysed indications and results of video-assisted thoracoscopic surgery (VATS) in complicated COVID-19 patients. This is a retrospective single-institution study analysing a case series of patients treated by VATS for secondary spontaneous pneumothorax (SSP), pneumatocele and empyema complicating COVID-19, not responding to drainage in Lodi Maggiore Hospital between February 2020 and May 2021. Out of 2076 patients hospitalized in Lodi Maggiore Hospital with COVID-19, nine Males (0,43%; mean age 58,1-33-81) were treated by VATS for complications of pneumonia (6 SSP and 3 empyema; 1 case complicated by haemothorax). 7 patients (77%) had CPAP before surgery for 21.3 days mean (4-38). Mean Operative time was 80.9 min (38-154). Conversion rate was 0%. 3 (33%) patients were admitted to ICU before VATS. Treatments were: bullectomy in six patients (66%), drainage of the pleural space in all patients, pleural decortication and fluid aspiration in five cases (55%). two patients (22%) needed surgery interruption and bilateral ventilation to restore adequate oxygenation. Mortality was 1/9 (11%) due to respiratory failure for persistent pneumonia. In one patient (11%) redo surgery was performed for bleeding. Mean postop Length of Stay (LOS) was 37.9 days (10-77). Our report shows that VATS can be considered an extreme, but effective treatment for COVID-19 patients with SSP, pneumatocele or empyema, for patients who can tolerate general anaesthesia. Attention must be paid to the aerosol-generation of infected droplets. |
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| MeSH term(s) | Male ; Humans ; Thoracic Surgery, Video-Assisted/adverse effects ; Thoracic Surgery, Video-Assisted/methods ; Retrospective Studies ; Empyema, Pleural/etiology ; Empyema, Pleural/surgery ; COVID-19/complications ; Pneumonia/etiology ; Length of Stay | |||||
| Language | English | |||||
| Publishing date | 2022-11-16 | |||||
| Publishing country | Italy | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 2572692-4 | |||||
| ISSN | 2038-3312 ; 2038-131X | |||||
| ISSN (online) | 2038-3312 | |||||
| ISSN | 2038-131X | |||||
| DOI | 10.1007/s13304-022-01420-4 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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