Low-cost Biportal Endoscopic Surgery for Primary Spontaneous Pneumothorax

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2015 May 15

PMID 25973237

Citations 2

Authors

Ansheng Mo

Yuzhong Luo

Xiaoping Yang

Shaoxiong Mo

Jun Wu

Yitong Wei

Affiliations

Soon will be listed here.

Abstract

Background: Like many other countries, including the United States, China faces the problem of rising health care costs, which have become a heavy burden on the state and individuals. Endoscopic surgery offers many benefits. However, the need for more expensive endoscopic consumables brings further high medical costs. Therefore, the development of video-assisted thoracic surgery with no disposable consumables will help to control medical cost escalation.

Methods: Between October 2011 and September 2014, a series of 66 patients with primary spontaneous pneumothorax underwent hand ligation of blebs under biportal video-assisted thoracoscopic surgery or bullectomy with stapler during triportal video-assisted thoracoscopic surgery. After treatment of blebs, pleural abrasion was performed with an electrocautery cleaning pad.

Results: Compared with the group treated by bullectomy with stapler, we found a significant reduction in postoperative costs in the group with bleb ligation. There was no difference in operating time, chest tube drainage, and postoperative stay between the two groups. The follow-up period varied from 1 to 35 months and six cases of recurrence were noted.

Conclusions: The technique that we described appears to offer better economic results than bullectomy with a stapler under three-port video-assisted thoracoscopic surgery for treating primary spontaneous. The clinical outcomes are similar.

Citing Articles

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References

Kang D, Min H, Jun H, Hwang Y, Kang M . Early outcomes of single-port video-assisted thoracic surgery for primary spontaneous pneumothorax. Korean J Thorac Cardiovasc Surg. 2014; 47(4):384-8. PMC: 4157502. DOI: 10.5090/kjtcs.2014.47.4.384. View

Luh S . Review: Diagnosis and treatment of primary spontaneous pneumothorax. J Zhejiang Univ Sci B. 2010; 11(10):735-44. PMC: 2950234. DOI: 10.1631/jzus.B1000131. View

Ardo N, Loizzi D, De Palma A, Caporale D, De Bellis R, Cialdella F . Comparison of two surgical approaches for the treatment of primary spontaneous pneumothorax*. G Chir. 2014; 35(5-6):122-5. PMC: 4321513. View

Watts J . China's health reforms tilt away from the market. Lancet. 2008; 371(9609):292. DOI: 10.1016/s0140-6736(08)60151-8. View

Yim A, Ho J . One hundred consecutive cases of video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. Surg Endosc. 1995; 9(3):332-6. DOI: 10.1007/BF00187780. View

Chang Y, Chou S, Kao E, Chuang H, Li H, Lee J . Video-assisted extrathoracic bleb excision: an ultra-minithoracotomy for primary spontaneous pneumothorax. Minim Invasive Ther Allied Technol. 2007; 16(6):323-7. DOI: 10.1080/13645700701702200. View

Orki A, Demirhan R, Ciftci H, Coskun T, Kutlu C, Arman B . Videothoracoscopic approach to recurrence primary spontaneous pneumothorax: using of electrocoagulation in small bulla/blebs. Indian J Surg. 2012; 71(1):19-22. PMC: 3452561. DOI: 10.1007/s12262-009-0005-8. View

Liu H, Chang C, Lin P, Hsieh M . Thoracoscopic loop ligation of parenchymal blebs and bullae: is it effective and safe?. J Thorac Cardiovasc Surg. 1997; 113(1):50-4. DOI: 10.1016/S0022-5223(97)70398-2. View

Liu Y, Chao Y, Wu Y, Hsieh M, Wu C, Lu M . Bullae ablation in primary spontaneous pneumothorax. World J Surg. 2009; 33(5):938-42. DOI: 10.1007/s00268-009-9928-2. View

10.

Cheng Y, Kao E . Prospective comparison between endosuturing and endostapling in treating primary spontaneous pneumothorax. J Laparoendosc Adv Surg Tech A. 2005; 14(5):274-7. DOI: 10.1089/lap.2004.14.274. View

11.

Chen C, Lee S, Chang H, Liu H, Hung T, Chen C . The adequacy of single-incisional thoracoscopic surgery as a first-line endoscopic approach for the management of recurrent primary spontaneous pneumothorax: a retrospective study. J Cardiothorac Surg. 2012; 7:99. PMC: 3504580. DOI: 10.1186/1749-8090-7-99. View

12.

Melton 3rd L, HEPPER N, Offord K . Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974. Am Rev Respir Dis. 1979; 120(6):1379-82. DOI: 10.1164/arrd.1979.120.6.1379. View

13.

Foroulis C, Anastasiadis K, Charokopos N, Antonitsis P, Antonitisis P, Halvatzoulis H . A modified two-port thoracoscopic technique versus axillary minithoracotomy for the treatment of recurrent spontaneous pneumothorax: a prospective randomized study. Surg Endosc. 2011; 26(3):607-14. DOI: 10.1007/s00464-011-1734-x. View

14.

Reinhardt U, Hussey P, Anderson G . U.S. health care spending in an international context. Health Aff (Millwood). 2004; 23(3):10-25. DOI: 10.1377/hlthaff.23.3.10. View

15.

Berlanga L, Gigirey O . Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax using a single-incision laparoscopic surgery port: a feasible and safe procedure. Surg Endosc. 2010; 25(6):2044-7. DOI: 10.1007/s00464-010-1470-7. View

16.

Salati M, Brunelli A . Uniportal VATS for pneumothorax and interstitial lung disease. J Thorac Dis. 2013; 5 Suppl 3:S217-20. PMC: 3771597. DOI: 10.3978/j.issn.2072-1439.2013.07.07. View

17.

Bense L, Eklund G, WIMAN L . Smoking and the increased risk of contracting spontaneous pneumothorax. Chest. 1987; 92(6):1009-12. DOI: 10.1378/chest.92.6.1009. View

18.

Al-Qudah A . Treatment options of spontaneous pneumothorax. Indian J Chest Dis Allied Sci. 2008; 48(3):191-200. View

19.

Costa D . Health and the Economy in the United States, from 1750 to the Present. J Econ Lit. 2015; 53(3):503-570. PMC: 4577070. DOI: 10.1257/jel.53.3.503. View

20.

Cheng Y, Chou S, Kao E . Video-assisted thoracoscopic suture closure of blebs to treat primary spontaneous pneumothorax. JSLS. 2004; 8(1):35-8. PMC: 3015511. View