Skip to main content
Log in

Long-term effect of a thoracoscopic stapled bullectomy alone for preventing the recurrence of primary spontaneous pneumothorax

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this retrospective study was to determine the long-term efficacy of a stapled bullectomy without any symphysial procedures under videoassisted thoracoscopic surgery (VATS).

Methods

A total of 121 sides of 112 patients who underwent a stapled bullectomy alone for primary spontaneous pneumothorax were retrospectively reviewed. There were 48 sides of 45 patients who underwent VATS (VATS group) and 73 sides of 67 patients who underwent open surgery (thoracotomy group).

Results

There were 12 recurrences that occurred during the follow-up periods in the VATS group (24.5%), and 3 in the thoracotomy group (4.1%). The cumulative recurrence rates in the VATS group at 2 and 10 years after a bullectomy were 16.3% and 27.5%, whereas in the thoracotomy group the recurrence rates were 2.9% and 4.9%, respectively (P < 0.001).

Conclusions

The long-term outcome of a VATS stapled bullectomy was unsatisfactory as a radical therapy for primary spontaneous pneumothorax. A symphysial procedure should therefore be added to VATS stapled bullectomy in order to prevent long-term postoperative recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Baumann HM, Strange C, Heffner EJ, Light R, Kirby TJ, Klein J, et al. Management of spontaneous pneumothorax an American College of Chest Physicians Delphi consensus statement. Chest 2001;119:590–602.

    Article  PubMed  CAS  Google Scholar 

  2. Horio H, Nomori H, Fuyuno G, Kobayashi R, Suemasu K. Limited axillary thoracotomy vs video-assisted thoracoscopic surgery for spontaneous pneumothorax. Surg Endosc 1998;12:1155–1158.

    Article  PubMed  CAS  Google Scholar 

  3. Horio H, Nomori H, Kobayashi R, Naruke T, Suemasu K. Impact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax. Surg Endosc 2002;16:630–634.

    Article  PubMed  CAS  Google Scholar 

  4. Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med 2000;342:868–874.

    Article  PubMed  CAS  Google Scholar 

  5. Czerny M, Salat A, Fleck T, Hofmann W, Zimpfer D, Eckersberger F, et al. Lung wedge resection improves outcome in stage I primary spontaneous pneumothorax. Ann Thorac Surg 2004;77:1802–1805.

    Article  PubMed  Google Scholar 

  6. Ayed AK, Al-Din HJ. The results of thoracoscopic surgery for primary spontaneous pneumothorax. Chest 2000;118:235–238.

    Article  PubMed  CAS  Google Scholar 

  7. Mouroux J, Elkaim D, Padovani B, Myx A, Perrin C, Rotomondo C, et al. Video-assisted thoracoscopic treatment of spontaneous pneumothorax. Technique and results of one hundred cases. J Thorac Cardiovasc Surg 1996;112:381–385.

    Google Scholar 

  8. Sakamoto K, Takei H, Nishii T, Maehara T, Omori T, Tajiri M, et al. Staple line coverage with absorbable mesh after thoracoscopic bullectomy for spontaneous pneumothorax. Surg Endosc 2004;18:478–481.

    Article  PubMed  CAS  Google Scholar 

  9. Lippert HL, Lund O, Blegvad S, Larsen HV. Independent risk factors for cumulative recurrence rate after first spontaneous pneumothorax. Eur Respir J 1991;4:324–331.

    PubMed  CAS  Google Scholar 

  10. Lang-Lazdunski L, Chapuis O, Bonnet PM, Pons F, Jancovici R. Videothoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term results. Ann Thorac Surg 2003;75:960–965.

    Article  PubMed  Google Scholar 

  11. Sawada S, Watanabe Y, Moriyama S. Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. Evaluation of indications and long-term outcome compared with conservative treatment and open thoracotomy. Chest 2005;127:2226–2230.

    Article  PubMed  Google Scholar 

  12. Ferguson L, Imrie WC, Hutchison J. Excision of bullae without pleurectomy in patients with spontaneous pneumothorax. Br J Surg 1981;68:214–216.

    Article  PubMed  CAS  Google Scholar 

  13. Barker A, Maratos CE, Edmonds L, Lim E. Recurrence rates of video-assisted thoracoscopic versus open surgery in the prevention of recurrent pneumothoraces: a systematic review of randomized and non-randomized trials. Lancet 2007;370:329–335.

    Article  PubMed  Google Scholar 

  14. Henry M, Arnold T, Harvey J. BTS guidelines for the management of spontaneous pneumothorax. Thorax 2003;58(suppl II):ii39–ii52.

    PubMed  Google Scholar 

  15. Tschopp J-M, Rami-Porta R, Noppen M, Astoul P. Management of spontaneous pneumothorax: state of the art. Eur Respir J 2006;28:637–650.

    Article  PubMed  Google Scholar 

  16. Ng CSH, Lee TW, Wan S, Yim APC. Video assisted thoracic surgery in the management of spontaneous pneumothorax: the current status. Postgrad Med J 2006;82:179–185.

    Article  PubMed  CAS  Google Scholar 

  17. Takeno Y. Present status of spontaneous pneumothorax in Japan. Ann Thorac Cardiovasc Surg 2000;6:81–85.

    PubMed  CAS  Google Scholar 

  18. Hazama K, Akashi A, Shigemura N, Nakagiri T. Less invasive needle thoracoscopic laser ablation of small bullae for primary spontaneous pneumothorax. Eur J Cardiothorac Surg 2003;24:139–144.

    Article  PubMed  Google Scholar 

  19. Sedrakyan A, Meulen J, Lewsey J, Treasure T. Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomized clinical trials. BMJ 2004;329:1008–1012.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakanishi, K. Long-term effect of a thoracoscopic stapled bullectomy alone for preventing the recurrence of primary spontaneous pneumothorax. Surg Today 39, 553–557 (2009). https://doi.org/10.1007/s00595-008-3934-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-008-3934-0

Key words

Navigation