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Preventing recurrence of spontaneous pneumothorax after thoracoscopic surgery: A review of recent results

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Abstract

Spontaneous pneumothorax (SP) is now commonly treated with thoracoscopic surgery, which is associated with less pain and a shorter hospital stay than thoracotomy; however, in its initial stages, thoracoscopic stapled bullectomy resulted in an unexpectedly high incidence of postoperative SP recurrence. Thus, new thoracoscopic procedures, designed to be performed in addition to stapled bullectomy, were developed, which resulted in a gradual decline in the postoperative recurrence rate. We review the recent literature on SP recurrence after thoracoscopic surgery with these other surgical procedures. Pleurectomy and pleural abrasion have been performed for a long time with low recurrence rates; however, they cause the lung to adhere to the parietal pleura, often resulting in complications such as postoperative bleeding. Other surgical procedures that may be recommended to minimize the risk of recurrence are reinforcement of the staple lines using fleece-coated glue or an absorbable sheet. These procedures are now considered to be the thoracoscopic treatment of choice for SP.

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References

  1. Crisci R, Coloni GF. Video-assisted thoracoscopic surgery versus thoracotomy for recurrent spontaneous pneumothorax. A comparison of results and costs. Eur J Cardiothorac Surg 1996;10: 556–560.

    Article  CAS  PubMed  Google Scholar 

  2. Kim KH, Kim HK, Han JY, Kim JT, Won YS, Choi SS. Transaxillary minithoracotomy versus video-assisted thoracic surgery for spontaneous pneumothorax. Ann Thorac Surg 1996;61:1510–1512.

    Article  CAS  PubMed  Google Scholar 

  3. Radberg G, Dernevik L, Svanvik J, Thune A. A comparative retrospective study of thoracoscopy versus thoracotomy for the treatment of spontaneous pneumothorax. Surg Laparosc Endosc 1995;5:90–93.

    CAS  PubMed  Google Scholar 

  4. Yim AP. Video-assisted thoracoscopic suturing of apical bullae. An alternative to staple resection in the management of primary spontaneous pneumothorax. Surg Endosc 1995;9:1013–1016.

    CAS  PubMed  Google Scholar 

  5. 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  CAS  PubMed  Google Scholar 

  6. Muramatsu T, Ohmori K, Shimamura M, Furuichi M, Takeshita S, Negishi N. Staple line reinforcement with fleece-coated fibrin glue (TachoComb) after thoracoscopic bullectomy for the treatment of spontaneous pneumothorax. Surg Today 2007;37:745–749.

    Article  CAS  PubMed  Google Scholar 

  7. Ayed AK, Al-Din HJ. Video-Assisted thoracoscopy versus thoracotomy for primary spontaneous pneumothorax: a randomized controlled trial. Med Principles Pract 2000;9:113–118.

    Article  Google Scholar 

  8. Dumont P, Diemont F, Massard G, Toumieux B, Wihlm JM, Morand G. Does a thoracoscopic approach for surgical treatment of spontaneous pneumothorax represent progress? Eur J Cardiothorac Surg 1997;11:27–31.

    Article  CAS  PubMed  Google Scholar 

  9. 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 

  10. Waller DA, Forty J, Morritt GN. Video-assisted thoracoscopic surgery versus thoracotomy for spontaneous pneumothorax. Ann Thorac Surg 1994;58:372–376; discussion 376–377.

    Article  CAS  PubMed  Google Scholar 

  11. Nakanishi K. Long-term effect of a thoracoscopic stapled bullectomy alone for preventing the recurrence of primary spontaneous pneumothorax. Surg Today 2009;39:553–557.

    Article  PubMed  Google Scholar 

  12. Chen JS, Hsu HH, Chen RJ, Kuo SW, Huang PM, Tsai PR, et al. Additional minocycline pleurodesis after thoracoscopic surgery for primary spontaneous pneumothorax. Am J Respir Crit Care Med 2006;173:548–554.

    Article  CAS  PubMed  Google Scholar 

  13. Cho S, Ryu KM, Jheon S, Sung SW, Kim BH, Huh DM. Additional mechanical pleurodesis after thoracoscopic wedge resection and covering procedure for primary spontaneous pneumothorax. Surg Endosc 2008;23:986–990.

    Article  PubMed  Google Scholar 

  14. 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 

  15. Marcheix B, Brouchet L, Renaud C, Lamarche Y, Mugniot A, Benouaich V, et al. Videothoracoscopic silver nitrate pleurodesis for primary spontaneous pneumothorax: an alternative to pleurectomy and pleural abrasion? Eur J Cardiothorac Surg 2007;31: 1106–1109.

    Article  PubMed  Google Scholar 

  16. 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  CAS  PubMed  Google Scholar 

  17. Cardillo G, Carleo F, Giunti R, Carbone L, Mariotta S, Salvadori L, et al. Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: a single-institution experience in 861 cases. J Thorac Cardiovasc Surg 2006;131:322–328.

    Article  PubMed  Google Scholar 

  18. Chang YC, Chen CW, Huang SH, Chen JS. Modified needlescopic video-assisted thoracic surgery for primary spontaneous pneumothorax: the long-term effects of apical pleurectomy versus pleural abrasion. Surg Endosc 2006;20:757–762.

    Article  PubMed  Google Scholar 

  19. Cheng YJ, Kao EL. Prospective comparison between endosuturing and endostapling in treating primary spontaneous pneumothorax. J Laparoendosc Adv Surg Tech A 2004;14:274–277.

    Article  PubMed  Google Scholar 

  20. Liu HP, Chang CH, Lin PJ, Hsieh MJ. Thoracoscopic loop ligation of parenchymal blebs and bullae: is it effective and safe? J Thorac Cardiovasc Surg 1997;113:50–54.

    Article  CAS  PubMed  Google Scholar 

  21. Liu YH, Chao YK, Wu YC, Hsieh MJ, Wu CY, Lu MS, et al. Bullae Ablation in Primary Spontaneous Pneumothorax. World J Surg 2009;33:938–942.

    Article  PubMed  Google Scholar 

  22. Leo F, Pastorino U, Goldstraw P. Pleurectomy in primary pneumothorax: is extensive pleurectomy necessary? J Cardiovasc Surg (Torino) 2000;41:633–636.

    CAS  Google Scholar 

  23. Bobbio A, Ampollini L, Internullo E, Caporale D, Cattelani L, Bettati S, et al. Thoracoscopic parietal pleural argon beam coagulation versus pleural abrasion in the treatment of primary spontaneous pneumothorax. Eur J Cardiothorac Surg 2006;29: 6–8.

    Article  PubMed  Google Scholar 

  24. Akiba T, Marushima H, Kobayashi S, Morikawa T. Video-assisted thoracic surgery for recurrent primary spontaneous pneumothorax in reoperated chests. Surg Today 2009;39:944–946.

    Article  PubMed  Google Scholar 

  25. Arano Y, Oyama K, Shibahara K, Tomita Y, Nozaki Z, Sasaki M, et al. Intractable pneumothorax for pleuritis carcinomatosis effectively treated with bronchial embolization: report of a case (in Japanese). Kyobu Geka 2003;56:981–985.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Respiratory Surgery, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchikamimachi, Itabashi-ku, Tokyo, 173-8610, Japan

    Takashi Muramatsu, Tatsuhiko Nishii, Shinji Takeshita, Shinichirou Ishimoto, Hiroaki Morooka & Motomi Shiono

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  1. Takashi Muramatsu
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  2. Tatsuhiko Nishii
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  3. Shinji Takeshita
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  4. Shinichirou Ishimoto
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  5. Hiroaki Morooka
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  6. Motomi Shiono
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Muramatsu, T., Nishii, T., Takeshita, S. et al. Preventing recurrence of spontaneous pneumothorax after thoracoscopic surgery: A review of recent results. Surg Today 40, 696–699 (2010). https://doi.org/10.1007/s00595-009-4208-1

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  • DOI: https://doi.org/10.1007/s00595-009-4208-1

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