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KMID : 0364020110440030225
Korean Journal of Thoracic and Cardiovascular Surgery
2011 Volume.44 No. 3 p.225 ~ p.228
Outcome of Video-assisted Thoracoscopic Surgery for Spontaneous Secondary Pneumothorax
Kim Sung-Jun

Lee Hee-Sung
Kim Hyoung-Soo
Shin Ho-Seung
Lee Jae-Woong
Kim Kun-Il
Cho Sung-Woo
Lee Won-Yong
Abstract
Background: Conventional treatment (i.e. chest tube insertion and chemical pleurodesis) still remains standard for patients with secondary spontaneous pneumothorax because the risk of surgical bullectomy is deemed high in this subset. However, it has been suggested that surgical treatment using thoracoscopy may expedite postoperative recovery and, thus, may reduce hospital stay.

Materials and Methods: Retrospective review of 61 patients with secondary spontaneous pneumothorax, who underwent conventional treatment (n=39) or video-assisted thoracoscopic surgery (VATS) (n=22) between January 2007 and December 2009, was performed. Talc was used for chemical pleurodesis in both groups.

Results: Hospital stay of conventional treatment group and VATS group was 14.2¡¾14.2 days (4¡­58 days) and 10.6¡¾5.8 days (5¡­32 days), respectively, with statistically significant difference (p=0.033). Recurrence rate of conventional treatment group was also significantly higher (12/39, 30%) compared to VATS group (1/22, 4.5%) (p=0.016).

Conclusion: In selected patients with secondary spontaneous pneumothorax with continuous air leak or inadequate lung expansion, thoracoscopic surgery with chemical pleurodesis using talc results in shorter hospital stay and lower recurrence rate compared to conventional approach.
KEYWORD
Pneumothorax, Thoracoscopy, Pleurodesis
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