Clinical Study after Video-Assisted Thoracic Surgery and Mid-Axillary Thoracotomy for Recurrent Spontaneous Pneumothorax

Lee, Jung Sang

Abstract

BACKGROUND: Although treatment of spontaneous pneumothorax by video-assisted thoracic surgery(VATS) has generally shown better clinical results than conventional thoracotomy, treatment of spontaneous pneumothorax by midaxillary thoracotomy(MAXT) has also shown good clinical results. The author studied to compare the clinical results of MAXT group I and VATS group II. MATERIAL AND METHOD: Group I included 30 midaxillary thoracotomy among 83 operative cases of spontaneous pneumothorax from Jan. 1992 to Dec. 1993. Group II included 30 VATS among 101 operative cases of pneumothorax from Jan. 1994 to Aug. 1995. The author selected the 30 patients, age 18 to 25 years, with recurrent spontaneous pneumothorax in each group. The author analyzed the operative indication, gender, operating time, amounts of the used staplers, tube drainage, total amounts of analgesics used during postoperative 24hr, tube stay time, postoperative complications and mortality. RESULT: The follow-up periods of both procedures were from 6 to 43 months. The operating time from start of skin incision to end of skin closure was 84.79+/-21.70(from 40 to 150) minutes in MAXT group I and 108.8+/-42.02(from 58 to 120) minutes in VATS group II(p<0.001). The numbers of the used staples useo was 1.31+/-0.6(from 0 to 3) in group I and 3.41+/-2.37(from 0 to 11) in group II. The amounts of postoperative 24hour tube drainage were 220.76+/-106.73(from 65 to 400) ml in group I and 260.63+/-233.18(from 70 to 320) in group II(p>0.05). The amounts of postoperative 24 hourly used analgesics(Tarasyn ) was 1.38+/-1.32(from 0 to 5) amples in group I and 0.72+/-1.02(from 0 to 4) amples in group II (p<0.05). The postoperative tube stay is 5.45+/-30.9 (from 3 to 7) days in group I and 4.75+/-3.1(9 from 2 to 14) days in group II(p>0.05). The number of complications after operations was 2 cases of prolonged air leakage in group I, and in group II. (P is not significant). The number of recurrence after the operation was one in group I and also one in group II(P is not significant). In conclusion, there were no statistical differences in the postoperative 24 hour chest tube drainage, days of postoperative tube stay, postoperative complications and recurrence in the analysis between group I and group II.
CONCLUSION
The author found that group II of VATS between 18 years and 25 years of age in recurrent spontaneous pneumothorax, statistically, requires longer operative time, more number of autosuture staples and less postoperative analgesic dosage than the midaxillary thoracotomy group.