Original articleGeneral thoracicStaple Line Coverage After Bullectomy for Primary Spontaneous Pneumothorax: A Randomized Trial
Section snippets
Study Design
Between October 2006 and July 2010, a total of 1,414 patients with PSP who underwent thoracoscopic bullectomy were enrolled in a prospective, multicenter, randomized, controlled study to investigate efficacy of coverage after thoracoscopic bullectomy. The minimum follow-up period was 1 year, and all except 16 patients who failed this requirement were followed up at least until June 2011. Eligibility criteria included ipsilateral or bilateral recurrent pneumothorax, history of previous
Patients
The median age of the 1,414 patients (1,295 male; 91.6%) was 18 years (range, 15 to 35 years), and 990 patients were never-smokers. Operations were performed for right pneumothorax in 652 patients (46.1%) and left pneumothorax in 761 patients (53.8%), with no clinical differences between the two groups (Table 1).
Operations
All underwent the VATS procedure successfully without conversion or mortality. Causes of operation were recurrent PSP (567 patients; 40.1%), tension pneumothorax (93 patients; 6.6%),
Comment
We set out to compare the prevention of PSP recurrence after thoracoscopic bullectomy by additional staple line coverage or additional mechanical pleurodesis. Although primary management of PSP is closed thoracostomy, the surgical indications for PSP have been broadened by advances in minimally invasive surgery and perioperative care. Video-assisted thoracic surgery has showed many advantages, such as reduced operation time, reduced drainage time, reduced complication rates, lower inflammatory
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Dr Sungsoo Lee's current address is Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.