Subscribe to RSS
DOI: 10.1055/s-2004-815800
© Georg Thieme Verlag Stuttgart · New York
Bilateral Video-Assisted Thoracoscopic Surgery in the Supine Position for Primary Spontaneous Pneumothorax
Publication History
Received June 23, 2003
Publication Date:
04 March 2004 (online)
![](https://www.thieme-connect.de/media/thoracic/200401/lookinside/thumbnails/10.1055-s-2004-815800-1.jpg)
Abstract
On the basis of the bilateral nature of bullous lesions of the lung, the authors have performed single-stage bilateral video-assisted thoracoscopic surgery (VATS) in the supine position for primary spontaneous pneumothorax in five patients since October 1999. All five patients were males with a mean age of 23 years (range 19 to 29 years). The presenting pneumothorax was ipsilateral (right-sided) in four patients and simultaneous bilateral in the one remaining patient. Apart from the one case of simultaneous bilateral spontaneous pneumothorax (SBSP), all patients had a history of at least one pneumothorax episode requiring tube thoracotomy. Bilateral bullae were confirmed in all patients on preoperative chest computed tomography (CT). Bilateral bullectomy was performed by endo-stapler with no difficulties. Mean operating time was 111 minutes (range 85 to 140 minutes). All patients were returned to the surgical ward in good condition from the operating room immediately after extubation. No complications were observed, and duration of postoperative hospital stay was two to four days. All patients were alive without recurrence of pneumothorax after a mean follow-up period of 25 months (range, 9 to 43 months). Single-stage bilateral VATS in the supine position has shown itself to be an excellent approach for the treatment of bilateral bullous lesions, combining both efficacy and low morbidity.
Key words
Bilateral - video-assisted thoracoscopic surgery (VATS) - pneumothorax - supine - unilateral - spontaneous pneumothorax
References
- 1 Baumann M H, Strange C. Treatment of spontaneous pneumothorax. A more aggressive approach?. Chest. 1997; 112 789-804
- 2 Baronofsky I D, Warden H G, Kaufman J L, Whatley J, Hanner J M. Bilateral therapy for unilateral spontaneous pneumothorax. J Thorac Surg. 1957; 34 310-322
- 3 Kalnins I, Torda T A, Wright J S. Bilateral simultaneous pleurodesis by median sternotomy for spontaneous pneumothorax. Ann Thorac Surg. 1973; 15 202-206
- 4 Driscoll P J, Aronstam E M. Experiences in the management of recurrent spontaneous pneumothorax. J Thorac Cardiovasc Surg. 1961; 42 174-178
- 5 Ikeda M, Uno A, Yamane Y, Hagiwara N. Median sternotomy with bilateral bullous resection for unilateral spontaneous pneumothorax, with special reference to operative indications. J Thorac Cardiovasc Surg. 1988; 96 615-620
- 6 Iwa T, Watanabe Y, Fukatani G. Simultaneous bilateral operations for bullous emphysema by median sternotomy. J Thorac Cardiovasc Surg. 1981; 81 732-737
- 7 Lang-Lazdunski L, de Kerangal, Pons F, Jancovici R. Primary spontaneous pneumothorax: one-stage treatment by bilateral videothoracoscopy. Ann Thorac Surg. 2000; 70 412-417
- 8 Bingisser R, Zollinger A, Hauser M, Bloch K E, Russi E W, Weder W. Bilateral volume reduction surgery for diffuse pulmonary emphysema by video-assisted thoracoscopy. J Thorac Cardiovasc Surg. 1996; 112 875-882
M. D. Shun-ichi Watanabe
The Second Department of Surgery · Kagoshima University Faculty of Medicine
8 - 35 - 1 Sakuragaoka
Kagoshima, 890-8520
Japan
Phone: + 81992755368
Fax: + 81 9 92 65 81 77
Email: shun@khosp2.kufm.kagoshima-u.ac.jp