Thoracoscopic stapled bullectomy supported by suturing.
In 1985, a thoracoscopic technique for closing bullae with hemostatic clips was developed. However, the method was limited, and therefore clinical application was small. A linear endoscopic stapler (Endo-GIA) was developed in 1990. The advent of the Endo-GIA nearly made thoracoscopic treatment of spontaneous pneumothorax practicable, and ended the use of clipping. In addition, a new operative technique was developed, the 3-cm minithoracotomy bullectomy for the treatment of spontaneous pneumothorax. This technique has now become obsolete. The current method is that of a thoracoscopic stapled bullectomy using the Endo-GIA, supported by suturing. The recurrence rate was 2.7% (1/37) using this method. The one recurrence occurred in a case where no bullae were observed during the operation. Our findings suggest that thoracoscopic stapled bullectomy supported by suturing is a practicable treatment of spontaneous pneumothorax. An economical use of the endoscopic stapler and complementary suturing may be less expensive than using a laser. Pleurodesis should be performed in the patients in whom no distinct bullae are discovered thoracoscopically.
Department of Thoracic Surgery, National Nishi-Niigata Hospital, Japan.
A
A
Yamaguchi
M
M
Shinonaga
S
S
Tatebe
T
T
Souma
M
M
Tsuchida
A
A
Saito
D006801:Humans; D008168:Lung / Q000601:surgery*; D011030:Pneumothorax / Q000453:epidemiology / Q000601:surgery*; D012008:Recurrence; D013528:Surgical Staplers; D013536:Suture Techniques; D013906:Thoracoscopy / Q000379:methods / Q000639:trends; D013908:Thoracotomy / Q000379:methods