Trial of a Synthetic Absorbable Staple Line Reinforcement for Preventing Recurrence after Performing Video-assisted Thoracoscopic Bullectomy for the Treatment of Primary Pneumothorax

Park, Jae Hong; Yoo, Byung Ha; Kim, Han Yong; Hwang, Sang Won; Kim, Myoung Young

Abstract

BACKGROUND: Postoperative recurrence is a major problem after performing video-assisted thoracic surgery for the treatment of primary pneumothorax. This study was designed to evaluate the efficacy and safety of a bioabsorbable staple line reinforcement (GORE SEAMGUARD(R)) for preventing recurrence after bullectomy. MATERIAL AND METHOD: From January 2000 to December 2004, 300 patients underwent video assisted thoracoscopic surgery for the treatment of primary penumothorax. 143 patients were treated with bioabsorbable staple line reinforcement (Group A) and 142 patients were treated with stapling of the bullae (Group B). Mechanical pleural abrasion was performed in all the patients. The operating time, the duration of the indwelling chest tube, the length of the hospital stay and the number of recurrences after operation were compared between the groups. RESULT: No operative deaths occurred. The conversion rate to an open procedure was 5% (15/300). Comparison with these groups (Group A versus Group B) showed the following results: the operating time (49.6+/-5.6 vs 51.8+/-0.4 minutes, respectively, p=0.514), the duration of an indwelling chest tube (5.8+/-.5 vs 7.2+/-.3 days, respectively, p<0.005), the hospital stay (10.9+/-4.3 vs 12.5+/-4.3 days, respectively, p<0.005) and the number of recurrences (14 (9.8%) vs 10 (7.0%), respectively, the over all rate: 8.4% p=0.523), and the mean follow up period (48.1+/-36.6 vs 36.5+/-24.4 months, respectively).
CONCLUSION
There were advantages to use synthetic absorbable staple line reinforcement over the usual method for the treatment of primary pneumothorax in regard to the duration of an indwelling chest tube and the hospital stay, but here was no significant difference between the groups for postoperative recurrence.