Video-assisted thoracic surgery(VATS) has been widely used in the treatment of spontaneous pneumothorax in spite of the absence of definitive data regarding the relative safety and long term results of this procedure. We reviewed 34
patients(group
I)
who underwnent 38 video-assisted surgical procedures for spontaneous pneumothorax from June 1994 to December 1995 and compared the results of these patients with the results of another 14 patients(group II) who underwent bullectomy through
axillary
thoracotomy during the same period.
Average age, sex distribution, site and extent of pneumothorax, surgical indications, and complication rate showed no differences between the two groups. In group II patients, the number and sites of bullse tend to be multiple compared to
patients
in
group I. The mean number of endo-GIA used for stapling of bullae was 2. 6 per patient with the range from 2 to 4 in group I.
The mean duratio of chest tube drainage was not different between the two groups(3.7 days and 3.9 days), but the mean time to discharge was significantly shorter in group I (5.6 days) than in group II(8.9 days). Mean follow-up time was 12 and 11
months
in each groups and ranged from 2 to 21 months. Pneumothorax recurred after three of 38 procedures in group I(7.9%) with no recurrence in group II.
These data suggest that video-assisted thoracic surgery is a viable alternative to thoracotomy for the treatment of spontaneous pneumothorax with low morbidity and shorter hospital stay. However, it should be applied cautiously to patients with
spontaneous pneumothorax because of the relatively high incidence of recurrence compared to axillary thoracotomy.
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