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Ann Thorac Surg 2000;70:253-257
© 2000 The Society of Thoracic Surgeons

Original articles: General thoracic

Long-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax

Rudolf A. Hatz, MDa, Michaela F. Kaps, MDa, Georgios Meimarakis, MDa, Florian Loehe, MDa, Christian Müller, MDa, Heinrich Fürst, MDa

a Department of Surgery and General Thoracic Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany

Address reprint requests to Dr Hatz, Department of Surgery and General Thoracic Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University, Marchioninistr 15, 81377 Munich, Germany
e-mail: hatz{at}gch.med.uni-muenchen.de

Background. Few investigators have reported on results after video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax (SP) with follow-up periods longer than 24 months. The aim of this study was to evaluate VATS for first-time and recurrent SP and to follow patients long-term.

Methods. One hundred nine patients were followed long-term after treatment of SP by VATS. Ninety-five patients had primary SP and 14 had secondary SP. Sixty-two patients had a first episode and 47 had a recurrence. In 72 patients leaks or ruptured blebs were identified and excised without subsequent pleurodesis. In 37 patients showing no ruptured bullae or leaks only pleurodesis was applied.

Results. Median follow-up was 53.2 months. Postoperative complications were rare. Three patients (2.7%) had a prolonged air leak. The long-term recurrence rate was 4.6%. Only those patients who had not received pleurodesis at the time of first treatment by VATS experienced recurrence.

Conclusions. Immediate postoperative results show VATS to be a safe and reliable method in first-time and recurrent SP to obtain quick reexpansion of the lung. Long-term recurrence rates are acceptable and compare with results after open thoracotomy. Pleurodesis should be included in each procedure for adequate recurrence prevention.




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