[Comparative studies of video-assisted thoracoscopic surgery versus thoracotomy for primary spontaneous pneumothorax]

Between April 1992 and March 1997, 32 patients with primary spontaneous pneumothorax were operated in our institution. In the first three years, 9 patients underwent thoracotomy which was classified into two groups axillary thoracotomy group (AX group) in 5 cases and postero-lateral thoracotomy group (PL group) in 4 cases. In the recent two years, 23 consecutive patients underwent video-assisted thoracoscopic surgery (VATS group). The operating time, intraoperative blood loss, serum CRP and CK level, the duration of the indwelling chest tube, postoperative hospital stay, the duration of epidural anesthesia, complications and recurrences were compared among the three groups. The CRP level was significantly lower in VATS group than in both AX group and PL group. The duration of indwelling chest tube and postoperative hospital stay were significantly less in VATS group than in both AX group and PL group. There was no significant difference in complications and recurrences among the three groups We conclude from findings that VATS is superior to thoracotomy in the treatment of primary spontaneous pneumothorax. However more careful intraoperative manipulation is required to prevent postoperative recurrence.