Low-cost biportal endoscopic surgery for primary spontaneous pneumothorax

Area of Science:

• Thoracic Surgery
• Surgical Innovation
• Health Economics

Background:

• Rising healthcare costs are a global challenge, impacting both national budgets and individual finances.
• Endoscopic surgery, while beneficial, incurs high costs due to disposable consumables.
• Developing cost-effective surgical techniques is crucial for managing escalating medical expenses.

Purpose of the Study:

• To compare the economic and clinical outcomes of hand ligation of blebs versus stapler bullectomy in treating primary spontaneous pneumothorax.
• To evaluate the feasibility of reducing medical costs associated with video-assisted thoracoscopic surgery.

Main Methods:

• A comparative study involving 66 patients with primary spontaneous pneumothorax between October 2011 and September 2014.
• Patients underwent either biportal video-assisted thoracoscopic surgery with hand ligation or triportal video-assisted thoracoscopic surgery with stapler bullectomy.
• Pleural abrasion was performed using an electrocautery cleaning pad after bleb treatment.

Main Results:

• The hand ligation group demonstrated a significant reduction in postoperative costs compared to the stapler bullectomy group.
• No significant differences were observed in operating time, chest tube drainage duration, or length of postoperative hospital stay between the two groups.
• Follow-up ranged from 1 to 35 months, with six cases of recurrence noted across both groups.

Conclusions:

• Hand ligation of blebs via video-assisted thoracoscopic surgery offers superior economic benefits for treating primary spontaneous pneumothorax compared to stapler bullectomy.
• The clinical outcomes of hand ligation are comparable to those of stapler bullectomy, making it a potentially more cost-effective approach.