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KMID : 0616620020080010061
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Journal of Soonchunhyang Medical College
2002 Volume.8 No. 1 p.61 ~ p.67
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Mapping of the bleb and surgical application following preoperative thoracoscopic examination and HRCT in spontaneous pneumothorax
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Abstract
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Spontaneous pneumothorax develops frequently in young, slender men and can be life threatening in a severe case. Treatment modalities consist of conservative treatment, thoracentesis and closed thoracostomy. However, for the radical treatment, bullectomy through open thoracotomy is necessary.
Recently video assisted thoracoscopic bulletomy has become popular as a principal surgical treatment modality. Video assisted thoracoscopic bulletomy has advantages over open thoracotomy in many aspects but the recurrence rate is higher than open thoracotomy because blebs can be missed in operation due to a limited operative view. Therefore, accurate diagnosis of bullae using appropriate diagnostic modalities is important before operation. To present, only chest radiography and computerized tomography have been used routinely in order to determine the location and degree of bullae. This study was performed to analyze and compare the efficacy of diagnostic modalities on patients who underwent preoperative thoracoscopic examination and HRCT with the final operative findings of subsequent video assisted thoracoscopic bullectomy.
A total of 35 patients with more than 50% pneumothorax who received thoracoscopic examination prior to closed thoracostomy and chest HRCT upon full expansion of the lung were enrolled in this prospective study. The presence and location of bullae in each modality were compared. On the basis of these data, video assisted thoracoscopic bullectomy was performed under general anesthesisa and final results were analyzed.
Comparions of the pre and post-operative findings lead to conclusion that chest HRCT was more effective than thoracoscopic examination on preoperative detection of bullae.
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