title: Thoracotomy versus VATS: is there an optimal approach to treating pneumothorax?
abstract: BACKGROUND
  The 2010 British Thoracic Society guidelines recommend that a weighted decision be made by clinicians with regard to surgical intervention for pneumothorax as the video assisted thoracoscopic surgery (VATS) approach is better tolerated by patients but carries a higher  rate of recurrence (5% vs 1%).
  
  
  METHODS
  Overall, 163 patients underwent surgical intervention for pneumothorax at our institution and data were collected prospectively for almost 7 years. Of these, 86 patients underwent VATS under a single surgeon with extensive VATS experience to compensate  for the associated learning curve while 79 patients underwent an open procedure.
  
  
  RESULTS
  There was no statistically significant difference in the recurrence rate between the open and the VATS group (1% vs 3.5%, p=1.0). The VATS group was superior to the open group in terms of reduced  postoperative bleeding (7.5% vs 0%, p=0.01), reduced number of intensive care unit admissions (16% vs 0%, p<0.01) and a reduced adjusted length of stay (3 vs 5.5 days, p<0.01).
  
  
  CONCLUSIONS
  A comparable recurrence rate is attainable with a VATS approach once  the learning curve is surpassed and a reduction in morbidity is an additional merit.
authors: Blackpool Teaching Hospitals NHS Foundation Trust, UK. vijayjoshi@doctors.net.uk
authors: V
authors: V
authors: Joshi
authors: B
authors: B
authors: Kirmani
authors: J
authors: J
authors: Zacharias
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D013908:Thoracotomy / Q000379:methods / Q000706:statistics & numerical data*