title: Outcome of Video-assisted Thoracoscopic Surgery for Spontaneous Secondary Pneumothorax.
abstract: BACKGROUND
  Conventional treatment (i.e. chest tube insertion and chemical pleurodesis) still remains standard for patients with secondary spontaneous pneumothorax because the risk of surgical bullectomy is deemed high in this subset. However, it has been suggested that surgical treatment using thoracoscopy may expedite postoperative recovery and, thus, may reduce hospital stay.
  
  
  METHODS
  Retrospective review of 61 patients with secondary spontaneous pneumothorax, who underwent conventional treatment (n=39) or video-assisted thoracoscopic surgery (VATS) (n=22) between January 2007 and December 2009, was performed. Talc was used for chemical pleurodesis in both groups.
  
  
  RESULTS
  Hospital stay of conventional treatment group and VATS group was 14.2±14.2 days (4~58 days) and 10.6±5.8 days (5~32 days), respectively, with statistically significant difference (p=0.033). Recurrence rate of conventional treatment group was also significantly higher (12/39, 30%) compared to VATS group (1/22, 4.5%) (p=0.016).
  
  
  CONCLUSIONS
  In selected patients with secondary spontaneous pneumothorax with continuous air leak or inadequate lung expansion, thoracoscopic surgery with chemical pleurodesis using talc results in shorter hospital stay and lower recurrence rate compared to conventional approach.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University, Korea.
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hee-Sung
authors.initials: HS
authors.lastname: Lee
authors.forename: Hyoung-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Ho-Seung
authors.initials: HS
authors.lastname: Shin
authors.forename: Jae-Woong
authors.initials: JW
authors.lastname: Lee
authors.forename: Kun-Il
authors.initials: KI
authors.lastname: Kim
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Cho
authors.forename: Won Yong
authors.initials: WY
authors.lastname: Lee