Staple line coverage with a polyglycolic acid sheet plus pleural abrasion by thoracoscopic surgery for primary spontaneous pneumothorax in young patients.
OBJECTIVE
We investigated surgical results of staple line coverage with a polyglycolic acid sheet plus pleural abrasion by thoracoscopic surgery for treating primary spontaneous pneumothorax in young patients.


METHODS
Forty-seven patients younger than 40 years underwent 48 thoracoscopic surgical procedures for spontaneous pneumothorax at the Division of Thoracic Surgery, Department of Surgery, Nippon Medical School, from May 2007 through August 2010. All patients underwent thoracoscopic bullectomy with stapling devices and pleural abrasion performed with a gauze sponge held by forceps until the pleura became petechial. Finally, the staple line was covered with a polyglycolic acid sheet (10 × 10 cm). No fibrin glue was used. We investigated both short-time results after surgery and the postoperative recurrence of pneumothorax.


RESULTS
There was no operative mortality or morbidity, such as air leakage from staple lines or hemorrhage due to pleural abrasion. Pneumothorax recurred after surgery in 3 cases. In 2 cases, neither re-operation nor tube thoracostomy was necessary because intrapleural adhesions allowed only partial collapse of the lung. One patient underwent re-operation for an overlooked bulla facing the diaphragm in left lower lobe of the lung 2 days after the first operation. The rate of freedom from pneumothorax 4 years after surgery was 94%.


CONCLUSIONS
Staple line coverage with a polyglycolic acid sheet plus pleural abrasion by thoracoscopic surgery is a useful method for preventing morbidity and the postoperative recurrence of pneumothorax.
Department of Biological Regulation and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan. shuji@nms.ac.jp
Shuji
S
Haraguchi
Kiyoshi
K
Koizumi
Iwao
I
Mikami
Junichi
J
Okamoto
Yoshihito
Y
Iijima
Takayuki
T
Ibi
Kazuo
K
Shimizu
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010994:Pleura / Q000187:drug effects* / Q000601:surgery*; D011030:Pneumothorax / Q000601:surgery*; D011100:Polyglycolic Acid / Q000494:pharmacology*; D017792:Surgical Stapling; D013906:Thoracoscopy / Q000379:methods*; D055815:Young Adult
D011100:Polyglycolic Acid