title: [Video-assisted thoracic surgery for pneumothorax in patients over fifty years of age].
abstract: BACKGROUND
  Pneumothorax in middle-aged and elderly patients has various different features from young patients. We set out to investigate the outcome and usefulness of video-assisted thoracic surgery (VATS) in this group.
  
  
  METHODS
  From January 1993 to August 2010, 168 patients underwent a total of 178 thoracoscopic surgeries. There were 160 men and 8 women with mean age of 67 (range, 50 to 85). The average duration of thoracic drainage before surgery was 7.4 days. We excised only responsible lesions as minimum degree of dissection as possible. When patients have intractable air leakage and chest computed tomography (CT) indicates severe pleural adhesions, pleurography should be performed to locate the site of air leakage and determine surgical approaches. One hundred and seventy patients were treated with the lateral approach, while 8 patients were successfully treated with the anterior approach. One hundred and fifty-one patients were treated with VATS alone, and 27 patients were treated with the combination of VATS and small thoracotomy. The duration of chest tube drainage, hospital stay, post-operative complication, outcome and recurrence were assessed.
  
  
  RESULTS
  The air leakages stopped and all patients except for 2 patents were discharged without drainage tubes. Postoperative drainage time was 4.5 +/- 3.4 days. Postoperative hospital stay was 9.9 +/- 13.9 days. One patient died caused by perioperative myocardial infarction. Seventeen patients died of other diseases. Seven patients needed local hospital treatments and the recurrence rate was 3.9%.
  
  
  CONCLUSIONS
  VATS for pneumothorax in patients over 50 years old is very useful by appropriate perioperative managements.
authors.affiliation: Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Oyama
authors.forename: T
authors.initials: T
authors.lastname: Onuki
authors.forename: M
authors.initials: M
authors.lastname: Kanzaki
authors.forename: T
authors.initials: T
authors.lastname: Isaka
authors.forename: T
authors.initials: T
authors.lastname: Kikkawa
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
authors.forename: K
authors.initials: K
authors.lastname: Sakamoto
authors.forename: H
authors.initials: H
authors.lastname: Komine
authors.forename: M
authors.initials: M
authors.lastname: Murasugi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D013908:Thoracotomy; D016896:Treatment Outcome