Experimental and Clinical Study of Staple-Line Reinforcement Using Expanded Polytetrafluoroethylene in Thoracoscopic Bullectomy for Spontaneous Pneumothorax.
- Author:
Seok Whan MOON
1
;
Sung Bo SIM
;
Young Pil WANG
;
Jeong Sub YOON
;
Keon Hyun JO
;
Jae Kil PARK
;
Man Sil PARK
;
Si Young CHOI
;
Moon Sub KWACK
;
Sun Hee LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, KangNam St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. swmoon@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Pneumothorax;
Thoracoscopy;
Surgical staplers;
Models, experimental
- MeSH:
Drainage;
Humans;
Length of Stay;
Lung;
Models, Theoretical;
Pneumothorax*;
Polytetrafluoroethylene*;
Recurrence;
Surgical Staplers;
Thoracoscopy;
Thoracotomy
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2003;36(12):904-910
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Thoracoscopic bullectomy (VATS-B) is now the preferred treatment for spontaneous pneumothorax despite of higher recurrence rate than open thoracotomy. Several methods have been used to prevent this problem. The effectiveness of staple line reinforcement (SLR) in VATA-B using endostaplers was assessed by clinical and experimental study. MATERIAL AND METHOD: In experimental study, canine lungs were harvested immediately (group I, N=5) and 48 hours (group II, N=5) after stapling. The pressures at which initial air leaks occurred were measured. In clinical study from February 1997 to March 1999, 106 procedures in 104 patients undergoing VATS-B for spontaneous pneumothorax were classified into two groups according to the presence of SLR and were compared. RESULT: The average pressure of the initial air leakage was significantly higher in SLR than that of staples alone (18+/-1.6 vs 48+/-3 mm Hg in group I; 23.8+/-1.9 vs 54+/-4.6 mm Hg in group II, p<0.001). In the clinical data, there were significant differences seen in the duration of drainage, the total length of endostaplers used, and the duration of the postoperative hospital stay between patients with staple alone and patients with SLR (4.4+/-1.4 vs 3.1+/-1.1 days in duration of drainage, 92.3+/-28.1 vs 71.1+/-30.6 mm in total length of endostaplers used, 5.9+/-1.9 vs 4.6+/-1.7 days in postoperative hospital stays, p<0.001). CONCLUSION: SLR was effective for preventing prolonged air leakage and responsible for shorter hospital stays after VATS-B for the treatment of spontaneous pneumothorax.
