[Thoracoscopic surgery versus axillary thoracotomy for spontaneous pneumothorax]

Area of Science:

• Thoracic Surgery
• Pulmonology
• Minimally Invasive Procedures

Background:

• Spontaneous pneumothorax is a condition requiring surgical intervention.
• Traditional axillary incision and newer thoracoscopic surgery are treatment options.
• Comparing the efficacy and outcomes of these surgical approaches is crucial.

Purpose of the Study:

• To compare the outcomes of axillary incision versus thoracoscopic surgery for spontaneous pneumothorax.
• To evaluate operative time, blood loss, hospital stay, pain management, and recurrence rates.
• To identify potential improvements in thoracoscopic techniques.

Main Methods:

• Retrospective analysis of 284 patients (204 axillary incision, 80 thoracoscopic surgery) under sixty years old.
• Data collected on operative time, intraoperative blood loss, drain duration, hospital stay, and postoperative analgesia.
• Recurrence rates were compared between the two groups.

Main Results:

• Thoracoscopic surgery had significantly shorter operating times (73.2 vs 111.3 min) and less blood loss (5.4 vs 65.6 g).
• Postoperative hospital stay was significantly shorter in the thoracoscopic group (8.0 vs 12.5 days).
• Postoperative analgesia use was significantly lower (58.9% vs 82.3%) in the thoracoscopic group, but recurrence rates were slightly higher (5.0% vs 2.9%).

Conclusions:

• Thoracoscopic surgery is a favorable option for spontaneous pneumothorax, offering significant benefits in recovery and resource utilization.
• The slightly increased recurrence rate in thoracoscopic surgery may be due to missed bullae, necessitating improved visualization techniques.
• Enhanced visualization, such as using electric bronchoscopes, and laser treatment for bullous emphysema show promise in improving outcomes.