Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS.
BACKGROUND
Video-assisted thoracic surgery has recently evolved as a viable alternative to thoracotomy for spontaneous pneumothorax.


METHODS
A series of 163 patients with primary spontaneous pneumothorax were treated by video-assisted thoracic surgery. Seventy patients were treated for a recurrent episode, 64 patients for a persistent primary spontaneous pneumothorax, 24 patients for a contralateral episode, and 5 patients for a bilateral primary spontaneous pneumothorax. Stapling of bullae with an Endo-GIA stapler (Auto-Suture, Elencourt, France) was performed in 90% of the cases and parietal pleural abrasion was performed in each case.


RESULTS
One revisional lateral limited thoracotomy was required for bleeding. Six patients had a prolonged air leak; 2 of them were reoperated on by lateral limited thoracotomy. Two patients have had an incomplete reexpansion of the lung and required a reoperation. The duration of hospitalization was 6.9 +/- 3 days. With a mean follow-up of 24.5 months, three recurrences requiring a reoperation occurred; 3 other patients had a partial recurrence and healed by rest without drainage. The mean time to return to the occupational activity of the patients was 42 +/- 34 days. These results were compared with those of a previous series of 87 patients operated on by lateral limited thoracotomy.


CONCLUSIONS
With the development of surgical technique and video equipment, video-assisted thoracic surgery will probably become the treatment of choice of primary spontaneous pneumothorax.
Bertrand
P C
PC
Department of Thoracic Surgery, Marie-Lannelongue Hospital, Le Plessis-Robinson, France.
Regnard
J F
JF
Spaggiari
L
L
Levi
J F
JF
Magdeleinat
P
P
Guibert
L
L
Levasseur
P
P
D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D010994:Pleura / Q000601:surgery; D011030:Pneumothorax / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013528:Surgical Staplers; D017792:Surgical Stapling; D013906:Thoracoscopy / Q000009:adverse effects; D013908:Thoracotomy; D016896:Treatment Outcome; D014741:Video Recording