Video-assisted thoracoscopic surgery management of primary spontaneous pneumothorax: Results in 110 consecutive cases

Primary spontaneous pneumothorax (PSP) results from the rupture of small blebs or bullae in a patient without any pre-existing lung disease. Last decade witnessed a paradigm shift in the surgical management of pneumothorax from open to video-assisted thoracoscopic surgery (VATS) method. In this study, we aim to report our single center experience of surgical management of PSP along with surgical outcomes in 110 consecutive cases of PSP.

This is a retrospective study of 110 operated cases of PSP over 5 years. Demography, computed tomography findings, operative technique, endoscopic classification (Vanderschueren), surgical duration, intraoperative and postoperative complications, duration of Intercostal Drain (ICD), hospital stay, and recurrence in follow-up were recorded.

The average age of patients was 27.59 years (range 9-68 years). The average number of episodes before the presentation was 2 (range 1-5). The average number of loss of working days because of symptoms, conservative management, or long-term intercostal drainage was 13.33 days (range 5-60 days). As per intra-operative findings, patients were categorized as per Vanderschueren's classification and managed accordingly. Conversion rate was in 1.8% (n = 2). Mean time to removal of chest tubes was 4 days (2-12 days). Mean hospital stay was 3.83 days (2-9 days). There were no postoperative deaths. The mean follow-up was 25.05 months (6-60 months). Overall complication rate was 3.6% (n = 4) and recurrence happened in 2.7% (n = 3) cases.

VATS is an efficient and safe treatment modality for PSP with low recurrence rates and high level of patient satisfaction.