Abstract
Background
Thoracoscopic simple bullectomy for primary spontaneous pneumothorax (PSP) has a relatively high postoperative recurrence rate and sometimes results in postoperative air leakage. One of the reasons for postoperative recurrence is the regrowth of bullae around the staple line. Therefore, reinforcement of the visceral pleura around the staple line is a reasonable way to prevent postoperative air leaks and recurrence. This study was done to determine the efficacy in preventing postoperative air leak and recurrent pneumothorax of widely covering the staple line with absorbable mesh after thoracoscopic bullectomy.
Methods
Wide coverage of the staple line with absorbable mesh was performed on 114 patients with PSP. These patients were retrospectively compared with 126 patients who underwent thoracoscopic simple bullectomy alone.
Results
The postoperative duration of chest drainage in the coverage group (mean, 1 day; range, 0–5) was significantly shorter than that in the simple bullectomy group (mean, 3 days; range 0–20). A prolonged air leak (>7 days) occurred in six patients in the simple bullectomy group, but there were no such leaks in the coverage group. Recurrent pneumothorax occurred in three patients (2.6%) in the coverage group and 12 patients (9.5%) in the simple bullectomy group.
Conclusion
Wide coverage of the staple line with absorbable mesh is effective in preventing postoperative air leak and in decreasing the recurrence rates of PSP.
Similar content being viewed by others
References
AK Ayed HJ Al-Din (2000) ArticleTitleThe results of thoracoscopic surgery for primary spontaneous pneumothorax. Chest 118 235–238 Occurrence Handle10.1378/chest.118.1.235 Occurrence Handle1:STN:280:DC%2BD3czpsVKrsw%3D%3D Occurrence Handle10893385
PC Bertrand JF Regnard L Spaggiari JF Levi P Magdeleinat L Guibert P Levasseur (1996) ArticleTitleImmediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Ann Thorac Surg 61 1641–1645 Occurrence Handle10.1016/0003-4975(96)00190-7 Occurrence Handle1:STN:280:BymB38ritlc%3D Occurrence Handle8651762
G Cardillo F Faccilo R Giunti R Gasparri M Lopergolo R Orsetti M Martelli (2000) ArticleTitleVideothoracoscopic treatment of primary spontaneous pneumothorax: a 6-year experience. Ann Thorac Surg 69 357–361 Occurrence Handle10.1016/S0003-4975(99)01299-0 Occurrence Handle1:STN:280:DC%2BD3c7pslOisg%3D%3D Occurrence Handle10735663
C Casadio O Rena R Giobbe R Rigoni G Maggi A Oliaro (2002) ArticleTitleStapler blebectomy and pleural abrasion by video-assisted thoracoscopy for spontaneous pneumothorax. J Cardiovasc Surg 43 259–263 Occurrence Handle1:STN:280:DC%2BD387lsVyitw%3D%3D
P Chan P Clarke FJ Daniel SR Knight S Seevanayagam (2001) ArticleTitleEfficacy study of video-assisted thoracoscopic surgery pleurodesis for spontaneous pneumothorax. Ann Thorac Surg 71 452–454 Occurrence Handle10.1016/S0003-4975(00)02446-2 Occurrence Handle1:STN:280:DC%2BD3M7nsVGjsw%3D%3D Occurrence Handle11235687
RA Hatz MF Kaps G Meimarakis F Loehe C Müller H Fürst (2000) ArticleTitleLong-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax. Ann Thorac Surg 70 253–257 Occurrence Handle10.1016/S0003-4975(00)01411-9 Occurrence Handle1:STN:280:DC%2BD3cvgvVKjtg%3D%3D Occurrence Handle10921718
H Horio H Nomori R Kobayashi T Naruke K Suemasu (2002) ArticleTitleImpact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax. Surg Endosc 16 630–634 Occurrence Handle10.1007/s00464-001-8232-5 Occurrence Handle1:STN:280:DC%2BD383jsVerug%3D%3D Occurrence Handle11972203
U Klinge V Schumpelick B Klosterhalfen (2001) ArticleTitleFunctional assessment and tissue response of short- and long-term absorbable surgical meshes. Biomaterials 22 1415–1424 Occurrence Handle11336316
M Loubani V Lynch (2000) ArticleTitleVideo assisted thoracoscopic bullectomy and acromycin pleurodesis: an effective treatment for spontaneous pneumothorax. Respir Med 94 888–890
A Maier U Anegg H Renner F Tomaselli B Fell R Lunzer O Sankin et al. (2000) ArticleTitleFour-year experience with pleural abrasion using a rotating brush during video-assisted thoracoscopy. Surg Endosc 14 75–78 Occurrence Handle10.1007/s004649900016 Occurrence Handle1:STN:280:DC%2BD3c7hs12nsQ%3D%3D Occurrence Handle10653242
J Mouroux D Elkaim B Padovani A Myx C Perrin C Rotomondo JM Chavaillon et al. (1996) ArticleTitleVideo-assisted thoracoscopic treatment of spontaneous pneumothorax: technique and results of one hundred cases. J Thorac Cardiovasc Surg 112 385–391 Occurrence Handle1:STN:280:BymA2M%2FgvV0%3D Occurrence Handle8751507
KS Naunheim MJ Mack SR Hazelrigg MK Ferguson PF Ferson TM Boley RJ Landreneau (1995) ArticleTitleSafety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax. J Thorac Cardiovasc Surg 109 1198–1204 Occurrence Handle1:STN:280:ByqB1MrjtlA%3D Occurrence Handle7776683
K Sakamoto M Kase I Tomiyama (1998) ArticleTitleReoperation for spontaneous pneumothorax. Kikyo 1 150–153
K Sakamoto M Kase M Mo H Kurata A Nagatomo H Kunikane H Okamoto et al. (1999) ArticleTitleRegrowth of bullae around the staple-line is one of the causes of postoperative recurrence in thoracoscopic surgery for spontaneous pneumothorax. Kyobu Geka 52 939–942 Occurrence Handle1:STN:280:DyaK1Mvkt1KmsA%3D%3D Occurrence Handle10513161
APC Yim HP Lin (1997) ArticleTitleVideo assisted thoracoscopic management of primary spontaneous pneumothorax. Surg Laparosc Endosc 7 236–240 Occurrence Handle10.1097/00019509-199706000-00012 Occurrence Handle1:STN:280:ByiA3sjlsVI%3D Occurrence Handle9194286
JAC Zijl HEJ Sinninghe Damste PJH Smits (2000) ArticleTitleVideo-assisted thoracoscopic introduction of talc in the treatment of recurrent spontaneous pneumothorax. Eur J Surg 166 283–285 Occurrence Handle10.1080/110241500750009087 Occurrence Handle1:STN:280:DC%2BD3czptFartQ%3D%3D Occurrence Handle10817321
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sakamoto, K., Takei, H., Nishii, T. et al. Staple line coverage with absorbable mesh after thoracoscopic bullectomy for spontaneous pneumothorax. Surg Endosc 18, 478–481 (2004). https://doi.org/10.1007/s00464-003-8918-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-003-8918-y