[Thoracoscopic surgery versus axillary thoracotomy for spontaneous pneumothorax].
From October 1974 through March 1995, 453 patients with spontaneous pneumothorax admited to our institution and 416 patients underwent an operation. Among them, except bilateral pneumothorax, 204 patients under sixty years of age underwent an axillary incision (Group Ax) and 80 patients underwent a thoracoscopic surgery (Group Ts). In Group Ax, 178 male and 26 female, median age was 26.6 years old and in Group Ts, 68 male and 12 female, median age was 24.6 years old. The median operating time was significantly shorter for patients in Group Ts than for those in Group Ax (73.2 versus 111.3 minutes; p < 0.05). The median intraoperative blood loss was significantly less in Group Ts than in Group Ax (5.4 versus 65.6 g; p < 0.01). There was no significant difference in the duration of intercostal drain placement between the two groups (2.1 versus 2.7 days) but the median postoperative hospital stay was significantly shorter in Group Ts than in Group Ax (8.0 versus 12.5 days; p < 0.01). 58.9% of the patients needed postoperative analgesia in Group Ts, while 82.3% of the patients in Group Ax, and it was significantly less in Group Ts. The rate of recurrent pneumothorax was more in Group Ts (5.0% versus 2.9%), because of fail to notice the bulla under the thoracoscopy. Recently we observe the thoracic cavity using electric bronchoscope in order that we may not miss the bulla, and we take laser treatment for bullous emphysema with much effect.
Matsuzoe
D
D
Second Department of Surgery, Fukuoka University School of Medicine, Japan.
Shirakusa
T
T
Kawahara
K
K
Iwasaki
A
A
Hayashi
K
K
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D004724:Endoscopy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000601:surgery*; D013906:Thoracoscopy; D013908:Thoracotomy