Is VATS Bullectomy and Pleurectomy an Effective Method for the Management of Spontaneous Pneumothorax?

Abstract

Spontaneous pneumothorax, primary or secondary, is a common medical emergency for which specific indications for surgical intervention are well defined in selected patients. The traditional surgical approach has been by limited thoracotomy using axillary or posterolateral incision. With the advent of video-assisted minimally invasive technique in the last 20 years the traditional approach is infrequently used. The definitive operation to prevent recurrent pneumothorax by surgical approach requires bullectomy and parietal pleurectomy. The recurrence rate after the traditional open surgical approach has been low at <2%. On the other hand, video-assisted thoracoscopic surgery, although better tolerated has a higher recurrence rate at 5% [1]. Information on post-operative morbidity and mortality are lacking. For this reason, we have reviewed our experience at one institution on the outcome of the VATS approach. We found that prolonged post- operative air leak is the most common complication and cigarette smoking remains an important associated factor.