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Ann Thorac Surg 1996;61:1641-1645
© 1996 The Society of Thoracic Surgeons

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Original Article: General Thoracic

Immediate and Long-Term Results After Surgical Treatment of Primary Spontaneous Pneumothorax by VATS

Department of Thoracic Surgery, Marie-Lannelongue Hospital, Le Plessis-Robinson, France

Accepted for publication February 15, 1996.

Background. Video-assisted thoracic surgery has recently evolved as a viable alternative to thoracotomy for spontaneous pneumothorax.

Methods. A series of 163 patients with primary spontaneous pneumothorax were treated by video-assisted thoracic surgery. Seventy patients were treated for a recurrent episode, 64 patients for a persistent primary spontaneous pneumothorax, 24 patients for a contralateral episode, and 5 patients for a bilateral primary spontaneous pneumothorax. Stapling of bullae with an Endo-GIA stapler (Auto-Suture, Elencourt, France) was performed in 90% of the cases and parietal pleural abrasion was performed in each case.

Results. One revisional lateral limited thoracotomy was required for bleeding. Six patients had a prolonged air leak; 2 of them were reoperated on by lateral limited thoracotomy. Two patients have had an incomplete reexpansion of the lung and required a reoperation. The duration of hospitalization was 6.9 ± 3 days. With a mean follow-up of 24.5 months, three recurrences requiring a reoperation occurred; 3 other patients had a partial recurrence and healed by rest without drainage. The mean time to return to the occupational activity of the patients was 42 ± 34 days. These results were compared with those of a previous series of 87 patients operated on by lateral limited thoracotomy.

Conclusions. With the development of surgical technique and video equipment, video-assisted thoracic surgery will probably become the treatment of choice of primary spontaneous pneumothorax.

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Invited Commentary

Stephen R. Hazelrigg
Ann. Thorac. Surg. 1996 61: 1645. [Extract] [Full Text]

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