30 patients with spontaneous pneumothorax underwent videothoracoscopic treatment between March and July 1992.
The patients ranged in age from 16 years to 62 years (mean age, 30.4 years) and the incidence according to age group was highest as 50% in the adolescence between 21 and 30 years old. The indications of the therapeutic videothoracoscopy for
spontaneous
pneumothorax were recurrence(30.8%), persistent air leak(30.8%), visible blebs on the chest X-ray(20.4%), tension pneumothorax(15.4%), and bilaterality(2.6%). Intraoperative scopic findings were as follows; blebs(87.1%), pleural adhesion (45.6%),
and
pleural effusion(22.6%).
The operation was performed under general anesthesia with one lung intubation guided by flexible fiberoptic bronchoscopy. Procedures included bleb and/or wedge resection, tetracycline pleurodesis with mechanical abrasion, and parietal
pleurectomy.
Successful treatment was obtained in 66.7% (20/30) and the mean postoperative hospital stay of the successful cases was 5 days. Videothoracoscopy also provided the benefits of lesser postoperative pain, rapid recovery, short. Hospitalization, and
smaller scar of wound by reduced trauma on access. The total 13 postoperative complications were occured in 10 patients, which showed somewhat higher rate than that of other reports because of lack of experiences in the earlier period, however,
it
had
decreased progressively as experiences were accu mulated and instruments were improved in the later period. The operative mortality was absent.
Conclusively, videothoracoscopy is a new interesting modality of surgical treatment of spontaneous pneumothorax and also can be extensively applicable in the diagnosis and treatment of other thoracic surgery. (Korean J Thoracic Cardiovas Surg
1994;
27:89-95)
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