Original articleLong-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax
Section snippets
Patient characteristics
Between June 1991 and June 1997, 118 consecutive patients were treated for SP by VATS. Nine patients were lost to follow-up; thus 109 patients could be followed long-term. In the group that was followed, 95 patients had suffered primary SP (PSP) and 14 patients secondary SP (SSP). Fifty-three patients in the PSP group experienced a pneumothorax for the first time and 42 had a recurrence (Table 1). In the SSP group 9 patients had a first episode and 5 had a recurrence. The underlying lung
Results
The median follow-up was 53.2 months (range, 2.0 to 86 months). This study was 92.4% complete. Nine patients could not be reached during follow-up. Of our patient population, 56.9% had a first episode of pneumothorax and 43.1% had their first or second recurrence. In 72 patients with first-time or recurrent episodes of both PSP or SSP in which ruptured blebs, bullae, or air leaks within normal lung tissue were identified, excision using an endostapling device was performed without subsequent
Comment
Although simple aspiration and chest tube drainage are still the most frequently applied methods for treatment of SP, especially the first episode, these procedures have major disadvantages. Prospective trials have shown that reexpansion of the collapsed lung is only achieved in approximately 60% to 70% after aspiration and 75% to 95% after chest tube drainage [13], and these treatment options do not prevent recurrence. A study by Schoenenberger and coworkers [8] showed 18% of patients with PSP
Acknowledgements
This study was supported by a research grant from the Chiles Foundation (Portland, OR). We thank Mrs Heide Leicht for assistance in preparing the manuscript.
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