European Journal of Cardio-Thoracic Surgery, Vol 10, 556-560, Copyright © 1996 by European Association for Cardio-thoracic Surgery
Video-assisted thoracoscopic surgery versus thoracotomy for recurrent spontaneous pneumothorax. A comparison of results and costs
R Crisci and GF Coloni
Department of Thoracic Surgery, University of L' Aquila, Teramo, Italy.
OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) represents at
present the most suitable treatment of recurrent spontaneous pneumothorax.
After three years we consider this interesting to draw up a trial balance
of our VATS experience in comparison with the cases treated before 1991
with the classic thoracotomic approach. METHODS: We have considered
retrospectively the results obtained in a series of 30 consecutive patients
with recurrent spontaneous pneumothorax treated with VATS between November
1991 and August 1994 in comparison with those obtained in a group of 30
patients previously treated with a traditional thoracotomy. The groups have
been selected in such a way that surgical indications, sex ratio, age and
number of episodes were homogeneous. The parameters we have compared were
the postoperative complications, the duration of chest drainage and
hospitalization, the operating times and the relapses. Besides these
technical parameters we considered the economic data too. RESULTS: On
average drains removal occurred one day before in VATS-Group: the time
spent in the Hospital was significantly shorter in VATS-Group, being on
average 1 week. Short term complications may be considered similar in the
two Groups. Prolonged air leaks occurred in 13% and 16% respectively.
Emothorax requesting reoperation occurred in 1 case for each Group. One
death occurred in thoracotomy-Group in an old patient presenting a severe
chronic respiratory insufficience with exacerbation in postoperative time.
We have registered 2 relapses after VATS and none after thoracotomy.
CONCLUSIONS: The study has demonstrated the therapeutic efficacy of VATS
and in the same time that in VATS the total economic cost is lower (22.7%)
in comparison with traditional thoracotomy.
