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Non-stapling thoracoscopic surgery for spontaneous pneumothorax in young patients

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Abstract

Objectives

Spontaneous pneumothorax in young patients has a high recurrence rate, even after surgical treatment, and bulla neogenesis around stapled lesions has been reported as a cause of postoperative recurrence. We investigate the clinical safety and long-term outcome of non-stapling thoracoscopic surgery for spontaneous pneumothorax in young patients.

Methods

Twenty-seven non-stapling thoracoscopic surgeries for pneumothorax in 24 patients younger than 25 years were retrospectively reviewed. The non-stapling surgical techniques used to treat bullae included thoracoscopic suture plication, soft-coagulation, covering, and ligation. Long-term follow-up was conducted by telephone or by a mailed questionnaire.

Results

In 22 (81.5%) operations, suture plication, soft-coagulation, and covering procedures were used in combination. The median number of bullae treated in one operation was 2 (range, 0–6). The median operative time was 97 min, and the median postoperative drainage and postoperative hospital stay periods were 1 and 3 days, respectively. No complications of grade 2 or higher were observed. Patients were followed for at least 30 (median, 37) months. The postoperative recurrence rate was 3.7%, with one case of recurrence due to bulla neogenesis at a distant site.

Conclusion

Non-stapling thoracoscopic surgery with covering procedure for pneumothorax in young patients might reduce postoperative recurrence.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzaki-Cho, Abeno-Ku, Osaka, 545-0053, Japan

    Hirofumi Suzuki

  2. Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachidori-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan

    Hirofumi Suzuki, Satoru Okada, Masanori Shimomura, Shunta Ishihara & Masayoshi Inoue

  3. Department of Thoracic Surgery, Otsu City Hospital, 2-9-9 Motomiya, Otsu, Shiga, 520-0804, Japan

    Hiroaki Tsunezuka

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  1. Hirofumi Suzuki
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Correspondence to Masayoshi Inoue.

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Suzuki, H., Tsunezuka, H., Okada, S. et al. Non-stapling thoracoscopic surgery for spontaneous pneumothorax in young patients. Gen Thorac Cardiovasc Surg (2023). https://doi.org/10.1007/s11748-023-01992-x

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