Modified Needlescopic Video-Assisted Thoracic Surgery for Primary Spontaneous Pneumothorax - the Long-Term Effects of Apical Pleurectomy Versus Pleural Abrasion
Resource
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES v.20 n.5 pp.757 -762
Journal
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Journal Volume
v.20
Journal Issue
n.5
Pages
75-7
Date Issued
2006
Date
2006
Author(s)
CHEN, CHUNG-WEI
HUANG, SHIH-HORNG
CHEN, JIN-SHING
Abstract
Background: The objective of this study was to evaluate the feasibility and safety of modified needlescopic videoassisted thoracic surgery (VATS) for treating primary spontaneous pneumothorax. The efficacy between apical pleurectomy and pleural abrasion through this technique was also compared . Methods: Between 2001 and 2003, 65 patients with primary spontaneous pneumothorax underwent modified needlescopic VATS procedures. The blebs were resected with endoscopic linear staplers. Pleurodesis was achieved by apical pleurectomy before September 2002 (n = 30) and by pleural abrasion for. the remainder of the study period (n = 35). Results: Mean operation time was 103 min in the pleurectomy group and 78 min in the abrasion group (p = 0. 001). Complications developed in four patients (6.2%): prolonged air leaks in three patients and wound infection in one patient. The mean postoperative hospital stay was 3.8 + /- 1.8 days. The two groups had comparable doses of requested analgesics, complication rates, post- operative chest tube and hospital stays, and postoperative pulmonary function test. Ipsilateral recurrence did not occur in any of the pleurectomy group patients after a mean follow-up of 31 months, but it occurred in three patients (8.6%) in the abrasion group after a mean follow-up of 19 months. Conclusions: Modified needlescopic VATS provides a feasible and safe procedure for treating primary spontaneous pneumothorax . In terms of efficacy, apical pleurectomy is more effective in preventing ipsilateral recurrence than pleural abrasion.
Subjects
needlescope
video-assisted thoracic surgery
spontaneous pneurnothorax
pleurectomy
pleural abrasion
Type
journal article