Video-assited thoracoscopic surgery (VATS) versus thoracotomy for spontaneous pneumothorax

Abstract

We compared patients undergoing video-assisted thoracoscopic surgery (VATS) and thoracotomy (OPEN) for spontaneous pneumothorax. (1) Surgical stress : Postoperative CPK, CRP, and WBC in the blood of VATS group were significantly lower than OPEN group, but plasma IL-6 levels in the two groups were equal. (2) Postoperative course : Duration of postoperative chest drainage and postoperative hospital stay of VATS group were significantly shorter than OPEN group. (3) Recurrence : The rate of postoperative recurrence of pneumothorax in VATS group was higher than in OPEN group. Collectively, VATS was almost equal to thoracotomy in surgical stress and was better than thoracotomy in the hospital stay and cosmesis, although VATS had a higher recurrence rate. These observations suggest that the indications for VATS do not apply to the aged pneumothorax patient and that new ways must be devised to reduce the recurrence rate.