[Thoracoscopic surgery of spontaneous pneumothorax and partial lung resection]

Fourty-five thoracoscopic operations were done from April 1992 to November 1993. There were 27 cases of pneumothorax, 13 cases of partial lung resection (8 lung biopsies, 3 resection of metastatic lesions, 2 benign lung tumors), 2 cases of mediastinal tumor and 3 other lesions. All procedures were performed under general anesthesia using a double lumen endobronchial tube, and the patient was positioned for a lateral or an axillary thoracotomy as in a standard operation. We operated through three or four trocar wounds of 5 to 12 mm. In case of pneumothorax, we basically used Nd-YAG laser ablation of the bullae but in a few cases that shrinkage of the bullae was not obtained by laser ablation alone we resected them by endoscopic stapler. All cases of partial lung resection were done using endoscopic stapler. Five patients(11.1%) were converted to standard thoracotomy. All the postoperative courses were uneventful and 8 patients(17.7%) did not use any drugs for pain postoperatively. Thoracoscopic surgery is a usefull procedure and has many advantages compared with conventional thoracotomy. However, if the procedure could result incomplete, thoracotomy should be followed without hesitation.