title: Preventing recurrence of spontaneous pneumothorax after thoracoscopic surgery: a review of recent results.
abstract: Spontaneous pneumothorax (SP) is now commonly treated with thoracoscopic surgery, which is associated with less pain and a shorter hospital stay than thoracotomy; however, in its initial stages, thoracoscopic stapled bullectomy resulted in an unexpectedly high incidence of postoperative SP recurrence. Thus, new thoracoscopic procedures, designed to be performed in addition to stapled bullectomy, were developed, which resulted in a gradual decline in the postoperative recurrence rate. We review the recent literature on SP recurrence after thoracoscopic surgery with these other surgical procedures. Pleurectomy and pleural abrasion have been performed for a long time with low recurrence rates; however, they cause the lung to adhere to the parietal pleura, often resulting in complications such as postoperative bleeding. Other surgical procedures that may be recommended to minimize the risk of recurrence are reinforcement of the staple lines using fleece-coated glue or an absorbable sheet. These procedures are now considered to be the thoracoscopic treatment of choice for SP.
authors.affiliation: Division of Respiratory Surgery, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchikamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Nishii
authors.forename: Shinji
authors.initials: S
authors.lastname: Takeshita
authors.forename: Shinichirou
authors.initials: S
authors.lastname: Ishimoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Morooka
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
mesh_terms: D006801:Humans; D007902:Length of Stay; D011030:Pneumothorax / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors; D055502:Secondary Prevention; D013906:Thoracoscopy / Q000009:adverse effects* / Q000379:methods; D013907:Thoracostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D013997:Time Factors