100 CONSECUTIVE CASES OF VIDEO-ASSISTED THORACOSCOPIC SURGERY FOR PRIMARY SPONTANEOUS PNEUMOTHORAX
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AbstractWe reviewed our experience on video-assisted thoracoscopic surgery (VATS) from our first 100 cases of primary spontaneous pneumothorax (PSP) performed at our institution from September 1992 to January 1994. Apical bullae were identified in 87% of cases. Mechanical pleurodesis with Marlex mesh was performed on all patients. Excision with endoscopic staple cutter was performed in 69 cases; an endoloop was used in five cases; ablation with an argon beam coagulator (ABC) was done in six cases; excision with endoscopic suturing occurred in seven cases; and mechanical pleurodesis alone was used in 13 cases. The overall median postoperative chest tube duration was 2 days (range 1-25 days) and hospital stay 4 days (range 1-30 days). Complications occurred in 8 cases (8%): 1 wound infection; 1 chest wall bleeding; and 6 persistent air leaks which lasted for more than 10 days (one of which eventually required an axillary thoracotomy for control). Procedure failure with recurrence occurred in three cases (3%) at a mean follow-up of 17 months (range and 24 months). The ABC group alone was responsible for one recurrence and two persistent leaks. We conclude that with the VATS approach in the treatment of PSP, staple resection of apical bullae is quick and most reliable but costly. Endoloop and hand suturing are applicable to selected patients with small and localized bullae and should be further studied, while our limited experience does not favor ABC as the primary treatment modality.
All Author(s) ListYIM APC, HO JKS
Journal nameSurgical Endoscopy
Year1995
Month3
Day1
Volume Number9
Issue Number3
PublisherSPRINGER VERLAG
Pages332 - 336
ISSN0930-2794
eISSN1432-2218
LanguagesEnglish-United Kingdom
KeywordsPRIMARY TREATMENT MODALITY; SPONTANEOUS PNEUMOTHORAX; VIDEO-ASSISTED THORACOSCOPIC SURGERY
Web of Science Subject CategoriesSurgery; SURGERY

Last updated on 2019-11-12 at 01:16