[Long-term results of thoracoscopic resection of lung cysts]

The treatment modality of spontaneous pneumothorax is extended by the introduction of an endoscopically applicable linear stapler. During the last 2 years 35 resections of cysts in 33 patients (24 men, 9 women, age median mean = 34 years) were started thoracoscopically in our hospital. Indications were: First pneumothorax (n = 15), recurrent pneumothorax (n = 16) and prophylactic resections (n = 4). A switch to open thoracotomy was necessary in 4 cases (11%) because of interpleural adhesions or large bullae. The median operation time was mean = 90 min. (range 60-240), the postoperative hospital stay mean = 8 days (range 4-25). Early complications occurred in 2 cases: One hematothorax, which was treated thoracoscopically, and one recurrent pneumothorax at the ninth postoperative day, which was treated by a chest drain. The follow up investigation 2 to 24 months (median mean = 6) after therapy was complete in 28 cases. It revealed that only 2 late recurrences (7%) occurred after 4 and 6 months. One was treated thoracoscopically again, the other one by thoracotomy. The endoscopically treated patients had less complaints than patients after thoracotomy. Only 4 patients complained of sensitivity in the scars due to weather changes. In conclusion the minimal-invasive resection of lung parenchyma represents an effective alternative to open thoracotomy with a much better quality of life, a low rate of complications and a comparable rate of recurrences.