Video-assisted thoracic surgery (VATS) is emerging as a viable alternatives to thoracotomy when surgical treatment of spontaneous pneumothorax is required. Apical blebs and bullaes of the lung can be resected, and pleural abrasion can be
accomplished
with minimal postoperative pain and a shorter postoperative stay in hospital. We compared our results with thoracoscopic management of spontaneous pneumothorax in 20 patients (group Ⅰ) with a group of 32 patients previously subjected to lateral
limited
thoracotomy (group Ⅱ). Indications for operation, sex distribution, and average age (group Ⅰ, 24.7 years; group Ⅱ, 34.4 years) were comparable. Operation time (112.42*54.7 min versus 124.8*35.3 min; P≤0.03) and chest tube duration (64.4*52.3
hours
versus 97.7*45.4 hours; P≤0.01) were less in group Ⅰ. Postoperative hospital stay was less in group Ⅰ(3.84*0.99 days; P≤0.01), as was the use of parenteral narcotics after 48 hours (5/20=25% versus 25/32=78%). Pain was quantitated by verbal
rating
scale in postoperative 1 to 3 days. Patients undergoing VATS experienced significantly less postoperative pain. Postoperative comp0lication was less in group Ⅰ(1/20=5% versus 3/32=8.3%). In conclusion, video-assisted thoracoscopic management of
spontaneous pneumothrax allows performance of the standard surgical procedure while a voiding the thoracotomy incision.
Video-assisted thoracic surgery (VATS) is safe and offers the potential benefits of shorter postoperative hospital stays and less pain with cosmetic benefits.
(Korean J Thorac Cardiovasc Surg 1995;28:297-302)
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