Needlescopic versus conventional video-assisted thoracic surgery for primary spontaneous pneumothorax

A comparative study

Jin Shing Chen, Hsao Hsun Hsu, Shuenn Wen Kuo, Pi Ru Tsai, Robert J. Chen, Jang Ming Lee, Yung Chie Lee

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background. Management of primary spontaneous pneumothorax by needlescopic video-assisted thoracic surgery (VATS) has rarely been attempted and no comparison study with conventional VATS is available. In this study, we compared the clinical outcomes of needlescopic VATS with conventional VATS in treating primary spontaneous pneumothorax. The technique and our experience with needlescopic VATS are reported. Methods. Between April 2001 and April 2002, a total of 63 patients with recurrent, persistent, or contralateral primary spontaneous pneumothorax were recruited for this study. Operative procedures included needlescopic VATS in 28 patients and conventional VATS in 35 patients. We used a modified operative technique to improve the poor and narrower vision of the needle-videothoracoscope. Results. There was no mortality or major complications in either of the two groups. Needlescopic and conventional VATS groups had comparable operation times, postoperative pain, requested doses of meperidine hydrochloride, durations of postoperative chest drainage, and length of hospital stay. After a mean follow-up of 8 months, the needlescopic VATS group had less residual neuralgia (p = 0.021) and better wound satisfaction (p = 0.043) than the conventional VATS group. Ipsilateral recurrence of pneumothorax occurred in 1 patient (3.6%) in the needlescopic VATS group but not in any patients in the conventional VATS group. Conclusions. Our experience showed that needlescopic VATS is technically feasible and can be a satisfactory alternative to conventional VATS in treating primary spontaneous pneumothorax. Limited vision of needlescopic VATS can be improved by the modified technique we used. However, conversion to conventional VATS or minithoracotomy is suggested in selected patients to prevent early recurrence.

Original languageEnglish
Pages (from-to)1080-1085
Number of pages6
JournalAnnals of Thoracic Surgery
Volume75
Issue number4
DOIs
Publication statusPublished - Apr 1 2003
Externally publishedYes

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Video-Assisted Thoracic Surgery
Pneumothorax
Primary Spontaneous Pneumothorax
Length of Stay
Recurrence
Meperidine
Operative Surgical Procedures
Neuralgia

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Needlescopic versus conventional video-assisted thoracic surgery for primary spontaneous pneumothorax : A comparative study. / Chen, Jin Shing; Hsu, Hsao Hsun; Kuo, Shuenn Wen; Tsai, Pi Ru; Chen, Robert J.; Lee, Jang Ming; Lee, Yung Chie.

In: Annals of Thoracic Surgery, Vol. 75, No. 4, 01.04.2003, p. 1080-1085.

Research output: Contribution to journalArticle

Chen, Jin Shing ; Hsu, Hsao Hsun ; Kuo, Shuenn Wen ; Tsai, Pi Ru ; Chen, Robert J. ; Lee, Jang Ming ; Lee, Yung Chie. / Needlescopic versus conventional video-assisted thoracic surgery for primary spontaneous pneumothorax : A comparative study. In: Annals of Thoracic Surgery. 2003 ; Vol. 75, No. 4. pp. 1080-1085.
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abstract = "Background. Management of primary spontaneous pneumothorax by needlescopic video-assisted thoracic surgery (VATS) has rarely been attempted and no comparison study with conventional VATS is available. In this study, we compared the clinical outcomes of needlescopic VATS with conventional VATS in treating primary spontaneous pneumothorax. The technique and our experience with needlescopic VATS are reported. Methods. Between April 2001 and April 2002, a total of 63 patients with recurrent, persistent, or contralateral primary spontaneous pneumothorax were recruited for this study. Operative procedures included needlescopic VATS in 28 patients and conventional VATS in 35 patients. We used a modified operative technique to improve the poor and narrower vision of the needle-videothoracoscope. Results. There was no mortality or major complications in either of the two groups. Needlescopic and conventional VATS groups had comparable operation times, postoperative pain, requested doses of meperidine hydrochloride, durations of postoperative chest drainage, and length of hospital stay. After a mean follow-up of 8 months, the needlescopic VATS group had less residual neuralgia (p = 0.021) and better wound satisfaction (p = 0.043) than the conventional VATS group. Ipsilateral recurrence of pneumothorax occurred in 1 patient (3.6{\%}) in the needlescopic VATS group but not in any patients in the conventional VATS group. Conclusions. Our experience showed that needlescopic VATS is technically feasible and can be a satisfactory alternative to conventional VATS in treating primary spontaneous pneumothorax. Limited vision of needlescopic VATS can be improved by the modified technique we used. However, conversion to conventional VATS or minithoracotomy is suggested in selected patients to prevent early recurrence.",
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