[Video-assisted thoracoscopic surgery for spontaneous pneumothorax].
OBJECTIVE
To explore the operational procedures, indications, and the long-term results of video-assisted thoracoscopic surgery (VATS) in the treatment of spontaneous pneumothorax.


METHODS
One hundred seventy three cases of spontaneous pneumothorax treated with VATS in our hospital between 1995 and 2001 were analyzed. Primary spontaneous pneumothorax (PSP) was found in 157 cases and secondary spontaneous pneumothorax (SSP) in 16 cases. In patients with PSP, pneumothorax occurred for the first time in 65 (41.4%) cases, and recurred at least once in 92 (58.6%) cases. Among them three patients underwent simultaneous bilateral VATS for simultaneous bilateral pneumothorax, and 6 underwent two-stage bilateral VATS. In patients with SSP, 6 had recurrent pneumothorax.


RESULTS
According to the Vanderschueren's classification, no abnormality was found in 34 (19.7%) cases, pleuro-pulmonary adhesions in 41 (23.7%) cases and bullae in 98 (56.7%) cases. Pleurodesis and stapling under Endo-cutter were the major operational procedures used in these cases. The median follow-up time was 53 months. The long-term recurrence rate was 1.8%. Complications related to surgery occurred in 3.0% of the cases, which included subcutaneous emphysema, localized pleural effusion and prolonged air leakage.


CONCLUSIONS
VATS is a safe and effective treatment for both initial and recurrent spontaneous pneumothorax, and therefore it is becoming the primary treatment modality for this disease.
Chen
Jing-yu
JY
Department of Thoracic Surgery, No.5 Hospital, Wuxi Pulmonary Hospital, China.
Zheng
Ming-feng
MF
Zhu
Qian-kun
QK
Zhu
Da-wei
DW
He
Yi-jun
YJ
Chen
Ruo
R
D005500:Follow-Up Studies; D006801:Humans; D011030:Pneumothorax / Q000145:classification / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D016896:Treatment Outcome