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KMID : 0978820060090020061
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2006 Volume.9 No. 2 p.61 ~ p.66
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Addition of Simple Mechanical Pleurodesis to Video-assisted Thoracoscopic Bullectomy in Patients with Primary Spontaneous Pneumothorax: A Study of Recurrence
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Min Tae-Gyun
Yoo Jae-Myoung
Yang Bong-Jun
Kim Jin-Seung
Paik Kwang-Jae
Choi Sang-Yong
Park Shin-Hee
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Abstract
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Purpose: Relatively high recurrence rates of pneumothorax have been documented after video-assisted thoracoscopic surgery without pleurodesis compared with thoracotomy. Thus, we evaluated the effectiveness of mechanical pleurodesis, including minimal pleurectomy and electrocoagulation, after video-assisted thoracoscopic surgery in preventing recurrence.
Methods: Respectively, 46 and 49 patients with or without mechanical pleurodesis were included in this study. They were treated by video-assisted thoracoscopic surgery with endo- loop ligatures or an endo-GIA stapler. Mechanical pleurodesis was performed by electrocoagulation and minimal pleurectomy at the apical area to avoid intercostal nerve injury. Operating time, number of resected bullae, intraoperative blood loss, length of hospital stay, duration of postoperative chest tube drainage, pain, and recurrence rate were analyzed retrospectively.
Results: Operating time, number of resected bullae, intraoperative blood loss, length of hospital stay, duration of postoperative chest tube drainage, and pain did not differ between the two groups with or without mechanical pleurodesis. The recurrence rates were 10.8% and 14.3%, respectively, which did not represent a significant statistical difference. There was no mortality or morbidity such as pneumonia, wound infection, cardiovascular disease or atelectasis.
Conclusion: Simple mechanical pleurodesis is not an effective method to prevent recurrence after video-assisted thoracoscopic surgery in primary spontaneous pneumothorax.
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KEYWORD
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Pleurodesis, Video-assisted thoracoscopic surgery, Pneumothorax
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