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Comparative study between using a stapler and hand sewing in bullectomy.

Mohammed M Mostafa1, Hesham H Ahmed2, Amr Ashry1

  • 1Department of Cardiothoracic Surgery, Assiut University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt.

Kardiochirurgia I Torakochirurgia Polska = Polish Journal of Cardio-Thoracic Surgery
|January 9, 2025
PubMed
Summary
This summary is machine-generated.

Bullectomy using staplers for spontaneous pneumothorax is more costly initially but reduces air leak duration and post-operative expenses. Hand sewing is cheaper upfront but leads to longer air leaks and higher costs.

Keywords:
bullectomyhand-sewingpneumothoraxstapler

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Area of Science:

  • Thoracic surgery
  • Pulmonology
  • Surgical techniques

Background:

  • Spontaneous pneumothorax (SP) is a critical condition, classified as primary (PSP) or secondary (SSP).
  • Surgery, including bullectomy with pleurectomy/pleurodesis, is standard for recurrent SP, persistent air leaks, or contralateral SP.

Purpose of the Study:

  • To compare the efficacy and cost-effectiveness of two bullectomy techniques: stapler-assisted versus hand-sewn repair.
  • To evaluate operative cost, air leak duration, post-operative stay, and re-exploration rates.

Main Methods:

  • Retrospective review of 60 patients undergoing thoracotomy for bullectomy and pleurectomy.
  • Patients were divided into two groups: Group A (30 patients) with stapler repair and Group B (30 patients) with hand-sewn repair.

Main Results:

  • The stapler group (A) had significantly higher operative costs (4400 EGP vs. 2733 EGP) (p=0.001).
  • The stapler group experienced significantly shorter air leak duration (1.8 days vs. 9.1 days) (p=0.0001) and lower post-operative costs (1000 EGP vs. 2060 EGP) (p=0.0001).
  • Re-exploration rates were similar between groups (3.3% vs. 6.6%) (p=0.5).

Conclusions:

  • While stapler bullectomy incurs higher initial operative costs, it leads to significant reductions in air leak duration, post-operative hospital stay, and overall post-operative costs.
  • Hand-sewn bullectomy is less expensive initially but associated with poorer outcomes regarding air leak and post-operative expenses.