Objective: Video-assisted thoracic surgery has been evaluated to replace thoracotomy for recurrent or persistent spontaneous pneumothorax. This study aimed to compare the clinical results and long-term follow-up of both procedures in treating primary spontaneous pneumothorax. Methods: In a prospective comparison, all 60 patients aged 14–57 years with recurrent or persistent primary spontaneous pneumothorax seen at the Chest Diseases Hospital in Kuwait were randomly allocated to treatment by video-assisted surgery or thoracotomy. Subsequently various factors were analysed and compared in both groups, and the follow-up of both procedures was 3 years. Results: The mean and standard deviation (SD) operating time was longer in the thoracotomy group (95.3 ± 16.4 min) than in those undergoing video-assisted thoracoscopy (77.5 ± 13.7 min; p < 0.0001). The mean ± SD amount of analgesics (Demerol) used in the first 12 h postoperatively was 67.16 ± 27.1 mg in the video-assisted thoracoscopy group and 148.3 ± 24.5 mg in the thoracotomy group (p < 0.0001). The mean 24-hour chest tube drainage was less in the video-assisted thoracoscopy group than in the thoracotomy group (82 vs. 347.1 ml; p < 0.0001). The mean duration of intercostal chest tube was 4.1 days in the thoracoscopy group and 5 days in the thoracotomy group (p = 0.18). The length of hospital stay was shorter in the thoracoscopy group than in the thoracotomy group (6.5 vs. 10.7 days; p < 0.0001). After a follow-up of 3 years, the number of recurrences was 3 in the thoracoscopy group and none in the thoracotomy group. Conclusion: Video-assisted thoracoscopy has many clinical advantages over thoracotomy for recurrent or persistent primary spontaneous pneumothorax; but it results in a higher recurrence rate. The future role of video-assisted thoracoscopic surgery in this disease remains to be determined by a larger study.

Keywords:
Thoracoscopy, Spontaneous pneumothorax, Thoracotomy
This content is only available via PDF.
© 2000 S. Karger AG, Basel
2000
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.