[Single-stage bilateral video-assisted thoracic surgery (VATS) in treatment of patients with primary spontaneous pneumothorax].
From January 2003 to April 2006, a total of 6 patients (mean age of 16.7 years) underwent single-stage bilateral VATS for primary spontaneous pneumothorax (PSP). All 6 patients had at least one episode of pneumothorax, requiring tube thoracostomy. Two patients had 2 previous ipsilateral episodes and 2 patients were with one episode in both sides each. One patient, operated on by VATS in another department, was with recurrence in the previously treated side. Chest CT revealed preoperatively bilateral apical bullae in 5 (83.3%) patients. Video-assisted thoracic suturing of apical bullae by Endo-Stitch was carried out in 8 pleural cavities, while in the last 2 pleural cavities apical bullae were resected using an Endo-GIA. Pleural abrasion was performed in 1 patient and the rest 5 patients had apical pleurectomy. Autologous fibrine glue was additionally applied in 3 cases for covering of suturing or resectional lines. No intraoperative complications or mortality were faced. The mean operative time was 87 minutes. No postoperative complications were observed. Mean duration of pleural drainage was 3.5 days. Postoperative hospital stay was 4.7 days. The mean follow-up was 10.3 months. One patient (the case without bullous pulmonary changes and with pleural abrasion) experienced left ipsilateral recurrence 19 months after the operation. He was reoperated on by VATS and apical pleurectomy was carried out. All patients restored their full working capacity within 1 month after the operation. They are doing well, no recurrence has been observed. In conclusion, we believe that single-stage bilateral operation by VATS is a safe procedure with excellent early and long-term results in patients with simultaneous bilateral PSP and in carefully selected young patients with ipsilateral PSP.
Petrov
D
D
Minchev
Ts
Ts
Terzinacheva
P
P
Aleksov
S
S
Kirova
G
G
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome