Video Assisted Thoracoscopic Surgery (VATS) for pneumothorax : a reason for unscheduled surgery ?

Timing of urgent surgery, with full schedules and the businesslike attitude of operating room management, can lead to animated discussions, affecting quality of care and job satisfaction. No publication appears to address the timing of definitive care for a stable, spontaneous, pneumothorax (SP) by unscheduled, or urgent, video assisted thoracoscopic surgery (VATS). We reviewed the literature and describe our series of 38 patients with SP and VATS. Of 185 patients with SP, 38 were presented for VATS. Of these 29% were unscheduled. Average time between diagnosis of SP and VATS was 11 days, with four days between decision for VATS and its execution. Post-operative antibiotics were prescribed to 37% of patients. There was a correlation between chest drain time in situ and infective signs (p = 0.001, rho = 0.654) as well as proven infections (p = 0.05, rho = 0.386), but not between for scheduled and unscheduled procedures. In conclusion, our case series and review did not identify reasons why VATS for SP should be performed as an urgent procedure, though we support more rapid planning.