Korean J Thorac Cardiovasc Surg.  2003 Dec;36(12):904-910.

Experimental and Clinical Study of Staple-Line Reinforcement Using Expanded Polytetrafluoroethylene in Thoracoscopic Bullectomy for Spontaneous Pneumothorax

• Moon SW
• Sim SB
• Wang YP
• Yoon JS
• Jo KH
• Park JK
• Park MS
• Choi SY
• Kwack MS
• Lee SH

Abstract

BACKGROUND: Thoracoscopic bullectomy (VATS-B) is now the preferred treatment for spontaneous pneumothorax despite of higher recurrence rate than open thoracotomy. Several methods have been used to prevent this problem. The effectiveness of staple line reinforcement (SLR) in VATA-B using endostaplers was assessed by clinical and experimental study. MATERIAL AND METHOD: In experimental study, canine lungs were harvested immediately (group I, N=5) and 48 hours (group II, N=5) after stapling. The pressures at which initial air leaks occurred were measured. In clinical study from February 1997 to March 1999, 106 procedures in 104 patients undergoing VATS-B for spontaneous pneumothorax were classified into two groups according to the presence of SLR and were compared. RESULT: The average pressure of the initial air leakage was significantly higher in SLR than that of staples alone (18+/-1.6 vs 48+/-3 mm Hg in group I; 23.8+/-1.9 vs 54+/-4.6 mm Hg in group II, p<0.001). In the clinical data, there were significant differences seen in the duration of drainage, the total length of endostaplers used, and the duration of the postoperative hospital stay between patients with staple alone and patients with SLR (4.4+/-1.4 vs 3.1+/-1.1 days in duration of drainage, 92.3+/-28.1 vs 71.1+/-30.6 mm in total length of endostaplers used, 5.9+/-1.9 vs 4.6+/-1.7 days in postoperative hospital stays, p<0.001).
CONCLUSION
SLR was effective for preventing prolonged air leakage and responsible for shorter hospital stays after VATS-B for the treatment of spontaneous pneumothorax.

Keyword

Pneumothorax; Thoracoscopy; Surgical staplers; Models, experimental

MeSH Terms

Drainage
Humans
Length of Stay
Lung
Models, Theoretical
Pneumothorax*
Polytetrafluoroethylene*
Recurrence
Surgical Staplers
Thoracoscopy
Thoracotomy
Polytetrafluoroethylene