VATS Versus Surgery for Management of Spontaneous Pneumothorax in Nasiriyah City: A Single Center Study

Abstract

Background: Pneumothorax is a clinical condition characterized by the accumulation of air in the pleural
space, leading to lung collapse. The management of pneumothorax can be conservative, interventional, or
surgical. (VATS) has emerged as a cornerstone of contemporary thoracic surgery, facilitating a shift toward
minimally invasive surgical techniques. This approach enables surgeons to perform intricate thoracic
procedures with enhanced visualization through a thoracoscope an elongated endoscopic instrument equipped
with a camera and light source thereby minimizing the need for extensive incisions typically required in
traditional thoracotomy.
Patients and Methods: The samples were collected from the hospitals of Thi-Qar Governorate (Al-Hussein
Teaching Hospital and Al-Nasiriyah Teaching Hospital from January 2022 to January 2025 after obtaining
approval from the official authorities to conduct the research Information about patients. Medical history,
symptoms, age, etc. was taken.
Results: Most patients affected by spontaneous pneumothorax were (15-30) years old. The presentation of the
patients was in the form unilateral chest pain, dyspnea and other signs and symptoms related to the thoracic
cage. The right side was affected more than the left side in our study and most patients indicated for VATS had
recurrent pneumothorax. No recurrence of spontaneous pneumothorax was recorded after management by
VATS.
Discussion: The Al-Mourgi & Alshehri study emphasized that smoking significantly increases the risk of
spontaneous pneumothorax, with heavy smokers facing up to 100 times the risk of non-smokers. All studies of
VATS show that VATS is of high value in the preventing recurrence of spontaneous pneumothorax and is
applied widely nowadays.
Conclusion: Video-Assisted Thoracic Surgery (VATS) has proven to be a highly effective and minimally
invasive technique for the management of spontaneous pneumothorax. The advantages of VATS is low
mortality rate, short hospital stay, cosmetic advantage, low recurrence rate, reduced postoperative pain and
complications, improved patient recovery.
Recommendations: Minimally Invasive: Unlike open-chest surgery, VATS requires only small incisions,
leading to less tissue damage, minimal bleeding, and a faster recovery time. Early Referral to Specialized
Thoracic Centers is always mandatory. Smoking Cessation Programs should be promoted, as smoking
significantly increases the risk of pneumothorax. Regular medical check-ups for high-risk individuals (e.g.,
tall, thin males, smokers, those with lung diseases) is indicated. Training and Investment in VATS is needed.