Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Kardiochir Torakochirurgia Pol. 2024 Mar;21(1):19-22. doi: 10.5114/kitp.2024.138497. Epub 2024 Mar 30.

Abstract

Introduction: Although primary spontaneous pneumothorax is a common disease in young adults, each thoracic surgery department performs different procedures for its management.

Aim: The optimal time of postoperative mobilization is not yet standardized in lung surgery.

Material and methods: This study included male patients with a primary spontaneous pneumothorax who underwent wedge resection of the upper lobe of the lungs via uniportal video-assisted thoracoscopic surgery. Patients were encouraged to stand up within the first postoperative hour. Mobilization was defined as standing and walking at least 100 m from the bed. If orthostatic hypotension occurred, mobilization was postponed for 30 min. Immediately after surgery, intravenous fluids were discontinued, and patients were instructed to drink water. The analgesic treatment needs, length of hospitalization, drainage, and discharge times were recorded.

Results: A total of 43 patients were operated on by the same surgeon. All operations were ended with uniportal video-assisted thoracoscopic surgery. Wedge resection is most commonly indicated for recurrent ipsilateral pneumothorax. Patients walked 345 (range: 150-510) m on the department corridor following bed rest. Paracetamol (2 g) and dexketoprofen (100 mg) were intravenously administered as postoperative analgesia to 76.7% of patients. Narcotic drugs were not needed.

Conclusions: Mobilization was recommended in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax.

Keywords: bleb; early ambulation; pain; recovery.