Abstract
Objective: We retrospectively evaluated the results of video-assisted thoracoscopic surgery for primary spontaneous pneumothorax and recurrence.Methods: A series of 424 patients with primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery-289 with an ipsilateral recurrent episode, 88 with persistent air leakage for 7 days or longer, 34 with a contralateral episode, 9 with hemopneumothorax, and 4 with tension pneumothorax. The commonest management was stapling of an identified bleb, undertaken in 375 patients (88.4%). Pleural abrasion was conducted in 250 (59.0%), but the abraded area was one-third or less of the thoracic cavity in 187 (74.8%).Results: No operative deaths occurred. Revisional thoracotomy was required in 1 patient with postoperative bleeding and another with incomplete postoperative lung reexpansion; 26 had prolonged air leakage, but none required revisional thoracotomy. During a mean follow-up of 31.4 months, ipsilateral pneumothorax recurred in 40 patients (9.4%), with 26 (65.0%) having recurrence within 1 year postoperatively. A video-assisted thoracoscopic surgery was conducted again in 8, and thoracotomy in 14.Conclusions: The ipsilateral recurrence of primary spontaneous pneumothorax after video-assisted thoracoscopic surgery was high at 9.4%. If video-assisted thoracoscopic surgery is to be considered as a treatment for spontaneous pneumothorax, we must therefore reduce postoperative ipsilateral recurrence by training practitioners not to overlook blebs during the procedure and/or consider widening the area of pleurodesis.
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References
Deslauriers J, Beaulieu M, Despres JP, Lemieux M, Leblanc J, Desmeules M. Transaxillary pleurectomy for treatment of spontaneous pneumothorax. Ann Thorac Surg 1980; 30: 569–74.
Granke K, Fischer CR, Gago O, Morris JD, Prager RL. The efficacy and timing of operative intervention for spontaneous pneumothorax. Ann Thorac Surg 1986; 42: 540–2.
Weeden D, Smith GH. Surgical experience in the management of spontaneous pneumothorax, 1972–82. Thorax 1983; 38: 737–43.
Waller DA, Forty J, Morritt GN. Video-assisted thoracoscopic surgery versus thoracotomy for spontaneous pneumothorax. Ann Thorac Surg 1994; 58: 372–7.
Naunheim KS, Mack MJ, Hazelrigg SR, Ferguson MK, Ferson PF, Boley TM, et al. Safety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax. J Thorac Cardiovasc Surg 1995; 109: 1198–204.
Bertrand PC, Regnard JF, Spaggiari L, Levi JF, Magdeleinat P, Guibert L, et al. Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Ann Thorac Surg 1996; 61: 1641–5.
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Ohno, K., Miyoshi, S., Minami, M. et al. Ipsilateral recurrence frequency after video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. Jpn J Thorac Caridovasc Surg 48, 757–760 (2000). https://doi.org/10.1007/BF03218248
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DOI: https://doi.org/10.1007/BF03218248