Video-assisted thoracic surgery (VATS) for spontaneous pneumothorax |
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Authors: | J F McCarthy D Lannon S McKenna A E Wood |
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Institution: | (1) Department of Cardiothoracic Surgery, Mater Misericordiae Hospital, Eccles Street, Dublin 7;(2) Department of Thoracic & Cardiovascular Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave. Desk F-25, 44195 Cleveland, Ohio, USA |
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Abstract: | Video-assisted thoracic surgery (VATS) involves using a thoracoscope with a camera chip attached to a video monitor which
allows certain thoracic procedures to be performed with limited incisions. Using VATS, 170 procedures have been performed
on 158 patients including 42 procedures on 39 patients with spontaneous pneumothorax. There were 24 males and 15 females with
age ranging from 17 to 84 yr (mean 36.7). Indication for operation included recurrent pneumothorax in 20 (51 per cent), persistent
pneumothorax in 16 (41 per cent) and bilateral pneumothorax in 3 (8 per cent). The main therapeutic strategies were apical
pleurectomy in all (42) and blebectomy/bullectomy in 38 (90 per cent). There was one hospital death (hospital mortality 2.5
per cent) in an elderly patient who developed multi organ failure post bullectomy and persistent air leak. One patient (2.5
per cent) required conversion to formal thoracotomy. Mean post-operative chest tube duration was 2.7 days and mean post-operative
hospital stay was 5.1 days. There has been no recurrence of pneumothorax in this series during short term follow up (mean
18 months). Our experience indicates an expanding role for video-assisted thoracic surgery in the management of patients with
spontaneous pneumothorax. |
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