Kozo Nakanishi1. 1. Department of General Thoracic Surgery, Iizuka Hospital, Iizuka, Fukuoka, Japan.
Abstract
PURPOSE: The purpose of this retrospective study was to determine the long-term efficacy of a stapled bullectomy without any symphysial procedures under videoassisted thoracoscopic surgery (VATS). METHODS: A total of 121 sides of 112 patients who underwent a stapled bullectomy alone for primary spontaneous pneumothorax were retrospectively reviewed. There were 48 sides of 45 patients who underwent VATS (VATS group) and 73 sides of 67 patients who underwent open surgery (thoracotomy group). RESULTS: There were 12 recurrences that occurred during the follow-up periods in the VATS group (24.5%), and 3 in the thoracotomy group (4.1%). The cumulative recurrence rates in the VATS group at 2 and 10 years after a bullectomy were 16.3% and 27.5%, whereas in the thoracotomy group the recurrence rates were 2.9% and 4.9%, respectively (P < 0.001). CONCLUSIONS: The long-term outcome of a VATS stapled bullectomy was unsatisfactory as a radical therapy for primary spontaneous pneumothorax. A symphysial procedure should therefore be added to VATS stapled bullectomy in order to prevent long-term postoperative recurrence.
PURPOSE: The purpose of this retrospective study was to determine the long-term efficacy of a stapled bullectomy without any symphysial procedures under videoassisted thoracoscopic surgery (VATS). METHODS: A total of 121 sides of 112 patients who underwent a stapled bullectomy alone for primary spontaneous pneumothorax were retrospectively reviewed. There were 48 sides of 45 patients who underwent VATS (VATS group) and 73 sides of 67 patients who underwent open surgery (thoracotomy group). RESULTS: There were 12 recurrences that occurred during the follow-up periods in the VATS group (24.5%), and 3 in the thoracotomy group (4.1%). The cumulative recurrence rates in the VATS group at 2 and 10 years after a bullectomy were 16.3% and 27.5%, whereas in the thoracotomy group the recurrence rates were 2.9% and 4.9%, respectively (P < 0.001). CONCLUSIONS: The long-term outcome of a VATS stapled bullectomy was unsatisfactory as a radical therapy for primary spontaneous pneumothorax. A symphysial procedure should therefore be added to VATS stapled bullectomy in order to prevent long-term postoperative recurrence.
Authors: Martin Czerny; Andreas Salat; Tatjana Fleck; Wolfgang Hofmann; Daniel Zimpfer; Franz Eckersberger; Walter Klepetko; Ernst Wolner; Michael-Rolf Mueller Journal: Ann Thorac Surg Date: 2004-05 Impact factor: 4.330
Authors: J Mouroux; D Elkaïm; B Padovani; A Myx; C Perrin; C Rotomondo; J M Chavaillon; B Blaive; H Richelme Journal: J Thorac Cardiovasc Surg Date: 1996-08 Impact factor: 5.209