Clinical analysis of some risk factors associated with recurrences after VATS for spontaneous pneumothorax

Abstract

In 299 cases of VATS (Video Assited Thoracic Surgery) for spontaneous pneumothorax, a recurrent rate of 40 cases, which had operations for the ipsilateral parts before, was 35.0%. This rate was significantly higher than that of other 259 cases, which did not have operations before, 4.6%. We analyzed the cases by two types of operations. One is a excision bullae with autosuturing divice, which we called type A, the other is suturing bullae with hand or looping ligation, which we called type B. In 259 cases, which did not have operations before, a recurrent rate of 236 cases operated by type A, was 5.1%. This rate was higher than that of other 23 cases operated by type B, 0%. In the 40 cases, which had operations before, a recurrent rate of 26 cases operated by type A, was 34.6%. This rate was similar to that of other 14 cases operated by type B, 35.7%. We divided the 40 cases into two groups. One is a group of 27 cases with additional reinforcement of visceral pleura, and the other is that of 13 cases without them. A recurrent rate of former group was 22.2%. This rate was lower than that of other group, 61.5%. Based on the analysis, it is considered that in cases not had operations before, a suturing bullae with hand or looping ligation is effective to prevent post operative recurrence, and in cases had operaions before, additional reinforcement of visceral pleura is effective.