Korean J Thorac Cardiovasc Surg.  2011 Jun;44(3):225-228.

Outcome of Video-assisted Thoracoscopic Surgery for Spontaneous Secondary Pneumothorax

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University, Korea.
  • 2Department of Thoracic and Cardiovascular Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Korea. lheecs@naver.com
  • 3Department of Thoracic and Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Korea.
  • 4Department of Thoracic and Cardiovascular Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Korea.
  • 5Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Korea.
  • 6Department of Thoracic and Cardiovascular Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Korea.

Abstract

BACKGROUND
Conventional treatment (i.e. chest tube insertion and chemical pleurodesis) still remains standard for patients with secondary spontaneous pneumothorax because the risk of surgical bullectomy is deemed high in this subset. However, it has been suggested that surgical treatment using thoracoscopy may expedite postoperative recovery and, thus, may reduce hospital stay.
MATERIALS AND METHODS
Retrospective review of 61 patients with secondary spontaneous pneumothorax, who underwent conventional treatment (n=39) or video-assisted thoracoscopic surgery (VATS) (n=22) between January 2007 and December 2009, was performed. Talc was used for chemical pleurodesis in both groups.
RESULTS
Hospital stay of conventional treatment group and VATS group was 14.2+/-14.2 days (4~58 days) and 10.6+/-5.8 days (5~32 days), respectively, with statistically significant difference (p=0.033). Recurrence rate of conventional treatment group was also significantly higher (12/39, 30%) compared to VATS group (1/22, 4.5%) (p=0.016).
CONCLUSION
In selected patients with secondary spontaneous pneumothorax with continuous air leak or inadequate lung expansion, thoracoscopic surgery with chemical pleurodesis using talc results in shorter hospital stay and lower recurrence rate compared to conventional approach.

Keyword

Pneumothorax; Thoracoscopy; Pleurodesis

MeSH Terms

Chest Tubes
Humans
Length of Stay
Lung
Pleurodesis
Pneumothorax
Recurrence
Retrospective Studies
Talc
Thoracic Surgery, Video-Assisted
Thoracoscopy
Talc
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