Modification of Thoracoscopic Surgery for Spontaneous Pneumothorax

Abstract

Morbidity, use of analgesics, postoperative drainage, and hospital stay are reduced after video-assisted thoracoscopic surgery for pneumothorax. However, some surgeons prefer a minithoracotomy because the rate of recurrence after thoracoscopic surgery is 5%-10%. A modified thoracoscopic bullectomy is described, which has the advantages of both conventional video-assisted thoracoscopic surgery and a minithoracotomy. Of 69 patients who underwent surgery for pneumothorax from January 2002 to February 2003, 13 were treated by conventional video-assisted thoracoscopic surgery and 21 by the modified thoracoscopic bullectomy. The mean ages were 20.6 years in the conventional group and 23.0 years in the modified group, with follow-up of 25.8 +/- 1.8 months in the conventional group and 20.6 +/- 1.3 months in the modified group. The duration of operation was similar in both groups (49.3 +/- 16.0 vs. 44.2 +/- 19.2 min). Significantly fewer staples were used in the modified group (1.62 +/- 0.74 vs. 2.92 +/- 1.19). The duration of chest tube drainage and postoperative hospital stay were significantly reduced in the modified group. The modified thoracoscopic bullectomy is an effective procedure for the treatment of primary spontaneous pneumothorax.