VIDEO-ASSISTED THORACIC-SURGERY (VATS) FOR SPONTANEOUS PNEUMOTHORAX

Video-assisted thoracic surgery (VATS) involves using a thoracoscope w ith a camera chip attached to a video monitor which allows certain tho racic procedures to be performed with limited incisions. Using VATS, 1 70 procedures have been performed on 158 patients including 42 procedu res on 39 patients with spontaneous pneumothorax. There were 24 males and 15 females with age ranging from 17 to 84 yr (mean 36.7). Indicati on 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 pleure ctomy in all (42) and blebectomy/bullectomy in 38 (90 per cent). There was one hospital death (hospital mortality 2.5 per cent) in an elderl y patient who developed multi organ failure post bullectomy and persis tent air leak. One patient (2.5 per cent) required conversion to forma l thoracotomy. Mean post-operative chest tube duration was 2.7 days an d mean post-operative hospital stay was 5.1 days. There has been no re currence of pneumothorax in this series during short term follow up (m ean 18 months), Our experience indicates an expanding role for video-a ssisted thoracic surgery in the management of patients with spontaneou s pneumothorax.