TRANSAXILLARY MINITHORACOTOMY VERSUS VIDEO-ASSISTED THORACIC-SURGERY FOR SPONTANEOUS PNEUMOTHORAX

Background. Although management of spontaneous pneumothorax by video-a ssisted thoracic surgery (VATS) has generally shown superior clinical results to thoracotomy, management of spontaneous pneumothorax by tran saxillary minithoracotomy (TAMT) has also shown good clinical results. The objective of this study was to compare the clinical results of VA TS and TAMT in treating spontaneous pneumothorax. Methods. Sixty-six p atients, aged 13 to 81 years, with recurrent, persistent or contralate ral spontaneous pneumothorax were involved in this study. Thirty-six p atients were treated by VATS and 30 by TAMT. The operating time, the a mount of analgesics used on the first postoperative day, the duration of the indwelling chest tube, and the number of recurrences after oper ation were compared. The follow-up periods of both procedures were fro m 6 to 24 months. Results. Of the 66 patients, 64 were male and 2 were female. The duration of operation, from start of skin incision to ins ertion of chest tube, was 91.2 +/- 36.8 minutes in VATS and 86.3 +/- 4 0.9 minutes in TAMT (p = 0.6061). The amount of analgesics (keptoprofe n) used was 1.9 +/- 2.3 ampules in VATS and 2.1 +/- 2.9 ampules in TAM T (p = 0.0883). The duration of indwelling chest tube was 5.0 +/- 4.0 days in VATS and 4.3 +/- 2.1 days in TAMT (p = 0.3707). The number of recurrences after operation was 4 in VATS and none in TAMT. Conclusion s. There were no advantages of VATS over TAMT for management of recurr ent, persistent, or contralateral spontaneous pneumothorax in regard t o the operating time, the amount of analgesics used on the first posto perative day, the duration of the indwelling chest tube, and the numbe r of postoperative recurrences in patients with apical bullae.