TREATMENT OF PRIMARY AND SECONDARY SPONTANEOUS PNEUMOTHORAX USING VIDEOTHORACOSCOPY

Our aim is to assess the results of surgical treatment for spontaneous pneumothorax (SP) using video-assisted thoracoscopic surgery (VATS) a nd to determine whether this technique is equally effective for primar y SP (PSP) and secondary SP (SSP). A prospective study was performed o n 54 patients with persistent and recurrent SP (42 PSPs and 12 SSPs). Mean operating time, time before drainage removal, and hospital stay w ere significantly longer with SSP (67.1 vs. 48.1 minutes; 5.4 vs. 3.6 days; and 7.7 vs. 5.3 days; p < 0.01, respectively). There was one con version due to bleeding (PSP). Postoperative complications were greate r with SSP (33% vs. 12%: p = 0.09). Although these were mild in all ca ses, the most common was air leak (25 vs. 5%; p = 0.06). The SP persis ted in three cases [2 (5%) with PSP, and 1 (8%) with SSP] and recurred in 2 (1 in each group; 2% and 8%, respectively). Follow-up averaged 2 4 months. VATS is effective in the surgical treatment of PSP and SSP, although the technical difficulty, morbidity rate, hospital stay, and incidence of persistences and recurrences are greater in the latter th an in the former.