MANAGEMENT OF PRIMARY SPONTANEOUS PNEUMOTHORAX BY VIDEO ASSISTED THORACOSCOPIC SURGERY (VATS)

Abstract

Objective: To evaluate the outcome of treatment of primary spontaneous pneumothorax by VATS
Study Design: Case Series
Place and Duration of study: Dept. of Thoracic Surgery Combined Military Hospital Rawalpindi between April 2007 to Dec 2009.
Patients and Methods: This study included 20 patients with primary spontaneous pneumothorax who were treated by VATS apical stapling and pleural abrasion / pleurectomy. All patients were operated under one lung ventilation. Three ports of 10mm were used and apical stappling / bullectomy was done with linear cutting stapler (ethicon, autosuture). This was combined with pleural abrasion / pleurectomy. Chest was drained via a single chest tube.
Results: We had 21 procedures on 20 patients. There were 18 males and 2 females (9:1). Mean age was 26.4years. Indications included persistent air leak 7, recurrent attack 12, contralateral recurrence 1 and professional hazard 1. Mean hospital stay was 3.2 days. Complications included minor port site infection 5, intercostal neuralgia 3, delayed lung expansion 2 cases and persistent apical space in 1 case. There is no recurrence.
Conclusion: VATS was a reliable approach for managing primary spontaneous pneumothorax with low morbidity.