[Advantages of video assisted thoracic surgery in the treatment of spontaneous pneumothorax].

Spontaneous pneumothorax (SP) is a disabling condition mostly affecting young, thin and otherwise healthy males. It is usually caused by ruptured pleural blebs. The first treatment is the insertion of a chest tube (ICT) but in a great number of patients there is recurrence of the disease. We believe that the video assisted thoracoscopy (VATS) is the best treatment possible because it allows us to treat the ruptured bleb radically avoiding any recurrence. In order to prove it, 40 patients admitted in a five-year period, with a SP, were randomly assigned to be treated by ICT or VATS. The ICT patients were in the hospital a mean time of 7.5 (4 to 15) days and the VATS patients, 5.3 (2 to 7) days (P < .05). ICT patients required analgesic drugs during 76.8 +/- 31 hours and VATS patients 38.4 +/- 13 hours (p < .05). From the ICT group, 8 (53%) patients had recurrence of the disease and 6 (40%) had a prolonged air leak, while none of the patients of the VATS group had any complication (< .001). Cost of ICT and VATS were $ 850 and $ 1730, respectively. According to these results, VATS should be the treatment of choice in SP patients. It treats the cause of the disease. It also reduces the hospitalization time, the use of analgesic drugs post surgery, decreases recurrence of the disease and the cost of the treatment. Moreover, the patients were back to work in less than 10 days.

RCT Entities:   Population Interventions Outcomes