TY - JOUR
T1 - Videothoracoscopic treatment of primary spontaneous pneumothorax
T2 - A 6- year experience
AU - Cardillo, Giuseppe
AU - Facciolo, Francesco
AU - Giunti, Roberto
AU - Gasparri, Roberto
AU - Lopergolo, Michele
AU - Orsetti, Remo
AU - Martelli, Massimo
PY - 2000/2
Y1 - 2000/2
N2 - Background. Timing and surgical approach in the treatment of primary spontaneous pneumothorax (PSP) are not well defined. The objective of this study is to propose a treatment protocol by videothoracoscopy (VATS) in PSP. Methods. From July 1992 to May 1998, 432 patients underwent VATS treatment of PSP. Indications were: recurrent ipsilateral pneumothorax: 322 cases; persistent air leak following a first episode: 93 patients; recurrence following VATS: 16 cases; recurrence following thoracotomy: 1 patient. Vanderschueren's classification was used for staging. Surgical indications were: stages 1 and II, subtotal pleurectomy or talc poudrage; stages III and IV, stapling or ligation of the bullae and subtotal pleurectomy or talc poudrage. Differences in recurrence rates were calculated to compare the specific procedures. Results. No postoperative deaths occurred. Complication rate was 4.16%. Conversion rate was 2.3%. Mean follow-up was 38 months (2 to 72 months). Overall recurrence rate was 4.4%. Specific recurrence rates following stapling and talc poudrage were, respectively, 1.27% and 1.79%. Talc poudrage and stapling of the bullae are respectively superior to subtotal pleurectomy (p <0.0001) and ligation (p <0.0001). Conclusions. Stapling of the bullae and talc poudrage by VATS represent the treatment of choice of PSP. (C) 2000 by The Society of Thoracic Surgeons.
AB - Background. Timing and surgical approach in the treatment of primary spontaneous pneumothorax (PSP) are not well defined. The objective of this study is to propose a treatment protocol by videothoracoscopy (VATS) in PSP. Methods. From July 1992 to May 1998, 432 patients underwent VATS treatment of PSP. Indications were: recurrent ipsilateral pneumothorax: 322 cases; persistent air leak following a first episode: 93 patients; recurrence following VATS: 16 cases; recurrence following thoracotomy: 1 patient. Vanderschueren's classification was used for staging. Surgical indications were: stages 1 and II, subtotal pleurectomy or talc poudrage; stages III and IV, stapling or ligation of the bullae and subtotal pleurectomy or talc poudrage. Differences in recurrence rates were calculated to compare the specific procedures. Results. No postoperative deaths occurred. Complication rate was 4.16%. Conversion rate was 2.3%. Mean follow-up was 38 months (2 to 72 months). Overall recurrence rate was 4.4%. Specific recurrence rates following stapling and talc poudrage were, respectively, 1.27% and 1.79%. Talc poudrage and stapling of the bullae are respectively superior to subtotal pleurectomy (p <0.0001) and ligation (p <0.0001). Conclusions. Stapling of the bullae and talc poudrage by VATS represent the treatment of choice of PSP. (C) 2000 by The Society of Thoracic Surgeons.
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U2 - 10.1016/S0003-4975(99)01299-0
DO - 10.1016/S0003-4975(99)01299-0
M3 - Article
C2 - 10735663
AN - SCOPUS:0034101731
VL - 69
SP - 357
EP - 362
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 2
ER -