Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Outcome of Video-assisted Thoracoscopic Surgery for Spontaneous Secondary Pneumothorax

  • Kim, Sung-Jun (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University) ;
  • Lee, Hee-Sung (Department of Thoracic and Cardiovascular Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kim, Hyoung-Soo (Department of Thoracic and Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Shin, Ho-Seung (Department of Thoracic and Cardiovascular Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Lee, Jae-Woong (Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kim, Kun-Il (Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Cho, Sung-Woo (Department of Thoracic and Cardiovascular Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Lee, Won-Yong (Department of Thoracic and Cardiovascular Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
  • Received : 2010.10.25
  • Accepted : 2011.05.11
  • Published : 2011.06.05
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Abstract

Background: Conventional treatment (i.e. chest tube insertion and chemical pleurodesis) still remains standard for patients with secondary spontaneous pneumothorax because the risk of surgical bullectomy is deemed high in this subset. However, it has been suggested that surgical treatment using thoracoscopy may expedite postoperative recovery and, thus, may reduce hospital stay. Materials and Methods: Retrospective review of 61 patients with secondary spontaneous pneumothorax, who underwent conventional treatment (n=39) or video-assisted thoracoscopic surgery (VATS) (n=22) between January 2007 and December 2009, was performed. Talc was used for chemical pleurodesis in both groups. Results: Hospital stay of conventional treatment group and VATS group was $14.2{\pm}14.2$ days (4~58 days) and $10.6{\pm}5.8$ days (5~32 days), respectively, with statistically significant difference (p=0.033). Recurrence rate of conventional treatment group was also significantly higher (12/39, 30%) compared to VATS group (1/22, 4.5%) (p=0.016). Conclusion: In selected patients with secondary spontaneous pneumothorax with continuous air leak or inadequate lung expansion, thoracoscopic surgery with chemical pleurodesis using talc results in shorter hospital stay and lower recurrence rate compared to conventional approach.

Keywords

References

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