Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results
2008 | 80 | 3 | 118-123

Article title

Video-Assisted Thoracoscopic Surgery (VATS) Vs Thoracotomy in the Surgical Treatment of Recurrent Spontaneous Pneumothorax


Title variants

Languages of publication



The aim of the study was to compare surgical treatment results in cases of recurrent spontaneous pneumothorax following video-assisted thoracoscopic surgery (VATS) and thoracotomy. We assessed the recurrence rate after the procedures and postoperative complications, considering two patient groups.Material and methods. The study group was comprised of 127 patients subjected to surgical treatment due to recurrent spontaneous pneumothorax during the period between 1996 and 2005. The group of 43 women and 84 men was between 15 and 79 years of age (mean age: 37 years). Video-assisted thoracoscopic surgery was performed in 67 cases, while the remaining 60 patients underwent thoracotomy. We performed the excision of the emphysematous blebs or apex of the lungs in 96 patients, partial pleurectomy with mechanical pleurodesis in 73 patients, subtotal pleurectomy in 33 cases, decortication of the lung in 30 cases, and chemical pleurodesis in 13 patients.Results. Pneumothorax recurrence was significantly more frequent in the group of patients following the minimally-invasive approach (28% vs 8%). We observed no statistically significant differences considering patient gender in both groups. However, the VATS approach had a tendency to be performed in younger patients (average 33 yrs. in VATS vs 42 yrs. in the thoracotomy group). We performed partial pleurectomy and mechanical pleurodesis more often during VATS, while subtotal pleurectomy and lung decortication were performed more frequently during thoracotomy. The percentage of resections, considering emphysematous blebs or lung apexes was similar in both patient groups. We observed no differences considering the duration and amount of postoperative drainage, hospitalization period, or percentage of postoperative complications (pleural hematoma, prolonged air leak, residual pneumothorax) between both groups.Conclusions. Apart from the excision of emphysematous blebs, subtotal pleurectomy should be considered in cases of patients subjected to video-assisted thoracoscopy. Subtotal pleurectomy could decrease the risk of recurrent pneumothorax, while having comparable percentages of postoperative complications as those following mechanical pleurodesis.








Physical description


1 - 3 - 2008
7 - 4 - 2008


  • Department of Thoracic Surgery, K. Marcinkowski Medical University, Poznań
  • Department of Thoracic Surgery, K. Marcinkowski Medical University, Poznań
  • Department of Thoracic Surgery, K. Marcinkowski Medical University, Poznań
  • Department of Thoracic Surgery, K. Marcinkowski Medical University, Poznań
  • Department of Thoracic Surgery, K. Marcinkowski Medical University, Poznań
  • Department of Thoracic Surgery, K. Marcinkowski Medical University, Poznań
  • Department of Thoracic Surgery, K. Marcinkowski Medical University, Poznań


  • Sawada S, Watanabe Y, Moriyama S et al.: Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. Chest 2005; 127: 2226-30.[PubMed]
  • Van Schil P: Cost analysis of video-assisted thoracic surgery versus thoracotomy: critical review. Eur Respir J 2003; 22: 735-38.[PubMed]
  • Mouroux J, Elkaim D, Padovani B et al.: Videoassisted thoracoscopic treatment of spontaneous pneumothorax: Technique and results of one hundred cases. J Thorac Cardiovasc Surg 1996; 112: 385-91.
  • Inderbitzi RG, Leiser A, Furrer M et al.: Three years experience in video-assisted thoracic surgery (VATS) for spontaneous pneumothorax. J Thorac Cardiovasc Surg 1994; 107: 1410-15.
  • Crisci R, Coloni GF: Video-assisted thoracoscopic surgery versus thoracotomy for recurrent spontaneous pneumothorax. A comparison of result and costs. Eur J Cardiothorac Surg 1996;10: 556-60.
  • Horio H, Nomori H, Fuyuno G et al.: Limited axillary thoracotomy vs video-assisted thoracoscopic surgery for spontaneous pneumothorax. Surg Endoscopy 1998; 12: 1155-58.
  • Lang-Lazdunski L, Chapuis O, Bonnet P et al.: Videothoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-therm results. Ann Thorac Surg 2003; 75: 960-65.
  • Atta HM, Latouf O, Moore J et al.: Thoracotomy versus video-assisted thoracoscopic pleurectomy for spontaneus pneumothorax. American Surgeon 1997; 63: 209-15.
  • Naunheim KS, Mack MJ, Hazelrigg SR et al.: Safety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax. J Thorac Cardiovasc Surg 1995; 109: 1198-03.
  • Massard G, Thomas P, Wihlm JM: Minimally invasive management for first and recurrent pneumothorax. Ann Thorac Surg 1998; 66: 592-99.[PubMed]
  • Freixinet JL, Canalis E, Gabriel J et al.: Axillary thoracotomy versus videothoracoscopy for the treatment of primary spontaneous pneumothorax. Ann Thorac Surg 2004; 78: 417-20.[PubMed]
  • Hatz R, Kaps M, Meimarakis G et al.: Long-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax. Ann Thorac Surg 2000; 70: 253-257.[PubMed]
  • Schramel FM, Sutedja TG, Braber JC et al.: Cost-effectiveness of video-assisted thoracoscopic surgery versus conservative treatment for first time of recurrent spontaneous pneumothorax. Eur Respir J 1996; 9: 1821-25.[PubMed]

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.