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Journal of Zhejiang University SCIENCE B 2008 Vol.9 No.4 P.335-340


Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax

Author(s):  Yi-jen CHEN, Shi-ping LUH, Kun-yen HSU, Cheng-ren CHEN, Thomas Chang-yao TSAO, Jia-yuh CHEN

Affiliation(s):  Department of Medicine, Chia-Yi Christian Hospital, 600 Chia-Yi, Taiwan, China; more

Corresponding email(s):   luh572001@yahoo.com.tw

Key Words:  Video-assisted thoracoscopic surgery (VATS), Spontaneous pneumothorax (SP)

Yi-jen CHEN, Shi-ping LUH, Kun-yen HSU, Cheng-ren CHEN, Thomas Chang-yao TSAO, Jia-yuh CHEN. Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax[J]. Journal of Zhejiang University Science B, 2008, 9(4): 335-340.

@article{title="Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax",
author="Yi-jen CHEN, Shi-ping LUH, Kun-yen HSU, Cheng-ren CHEN, Thomas Chang-yao TSAO, Jia-yuh CHEN",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax
%A Yi-jen CHEN
%A Shi-ping LUH
%A Kun-yen HSU
%A Cheng-ren CHEN
%A Thomas Chang-yao TSAO
%A Jia-yuh CHEN
%J Journal of Zhejiang University SCIENCE B
%V 9
%N 4
%P 335-340
%@ 1673-1581
%D 2008
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0720235

T1 - Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax
A1 - Yi-jen CHEN
A1 - Shi-ping LUH
A1 - Kun-yen HSU
A1 - Cheng-ren CHEN
A1 - Thomas Chang-yao TSAO
A1 - Jia-yuh CHEN
J0 - Journal of Zhejiang University Science B
VL - 9
IS - 4
SP - 335
EP - 340
%@ 1673-1581
Y1 - 2008
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0720235

Objective: To review our experience of the treatment of bilateral primary spontaneous pneumothorax (PSP) by video-assisted thoracoscopic surgery (VATS). Materials and methods: Retrospective chart review was followed by an on-clinic or telephone interview. Patients were cared for by one thoracic surgeon in four medical centers or community hospitals in Northern and Central Taiwan. Thirteen patients with bilateral PSP underwent bilateral VATS simultaneously or sequentially from July 1994 to December 2005. Results: Twelve males and one female, with age ranging from 15 to 36 years (mean 23.1 years), were treated with VATS for bilateral PSP, under the indications of bilateral pneumothoracis simultaneously (n=4) or sequentially (n=9). The interval between the first and second contra-lateral VATS procedure for non-simultaneous PSP patients ranged from 7 d to 6 years. Eleven of 13 patients (84.6%) had prominent pulmonary bullae/blebs, and underwent bullae resection with mechanical or chemical pleurodesis. The mean operative time was (45.6±18.3) min (range 25~96 min) and (120.6±28.7) min (range 84~166 min) respectively for the non-simultaneous (second VATS for the recurrence of contralateral side after first VATS) and simultaneous (bilateral VATS in one operation) procedures. There was no postoperative mortality. However, prolonged air leakage (>7 d) occurred in one patient (7.7%) who recovered after conservative treatment. The mean duration of chest tube drainage was 3.1 d and the median follow up period was 3.4 years. Conclusions: VATS is a safe and effective procedure in the treatment of bilateral PSP. Bilateral VATS is only recommended for patients with simultaneously bilateral PSP, because the incidence of recurrence, even with visible bullae, was not so high in my group and in some previous literature. Bilateral VATS in a supine position should only be used in selective cases, because of possible pleural adhesion or hidden bullae on the posterior side.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1] Abdala, O.A., Levy, R.R., Bibiloni, R.H., Viso, H.D., de Souza, M., Satler, V.H., 2001. Advantages of video assisted thoracic surgery in the treatment of spontaneous pneumothorax. Medicina, 61:157-160.

[2] Ayed, A.K., 2002. Bilateral video-assisted thoracoscopic surgery for bilateral spontaneous pneumothorax. Chest, 122(6):2234-2237.

[3] Baumann, M.H., Strange, C., 1997. Treatment of spontaneous pneumothorax: a more aggressive approach? Chest, 112(3):789-804.

[4] Bertrand, P.C., Regnard, J.F., Spaggiari, L., 1996. Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Ann. Thorac. Surg., 61(6):1641-1645.

[5] Cardillo, G., Facciolo, F., Glunti, R., Gasparri, R., Lopergolo, M., Orsetti, R., Martelli, M., 2000. Videothoracoscopic treatment of primary spontaneous pneumothorax: a 6-year experience. Ann. Thorac. Surg., 69(2):357-362.

[6] Casadio, C., Rena, O., Giobbe, R., Rigoni, R., Maggi, G., Oliaro, A., 2002. Stapler blebectomy and pleural abrasion by video-assisted thoracoscopy for spontaneous pneumothorax. J. Cardiovasc. Surg., 43:259-262.

[7] Chen, J.S., Hsu, H.H., Kuo, S.W., Tsai, P.R., Chen, R.J., Lee, J.M., Lee, Y.C., 2004. Effects of additional minocycline pleurodesis after thoracoscopic procedures for primary spontaneous pneumothorax. Chest, 125(1):50-55.

[8] Connolly, S.S., Hurson, C., Lynch, V., 2002. Thoracoscopic management of primary spontaneous pneumothorax. Irish. J. Med. Sci., 17:71-72.

[9] Hatz, R.A., Kaps, M.F., Meimarakis, G., Meimarakis, G., Loehe, F., Müller, C., Fürst, H., 2000. Long-term results after video-assisted thoracoscopic surgery for first time and recurrent spontaneous pneumothorax. Ann. Thorac. Surg., 70(1):253-257.

[10] Huang, P.M., Chang, Y.L., Hsu, H.H., Chen, J.S., Lee, J.M., Lee, Y.C., 2005. Supine position with alternating inflation pneumatic cuffs in video-assisted thoracoscopic surgery for bilateral pneumothorax. J. Thorac. Cardiovasc. Surg., 129(2):437-439.

[11] Hunt, I., The, E., Southon, R., Treasure, T., 2007. Using non-steroidal anti-inflammatory drugs (NSAIDs) following pleurodesis Interact. Cardiovasc. Thorac. Surg., 6:102-104.

[12] Ikeda, M., Uno, A., Yamane, Y., Hagiwara, N., 1988. Median sternotomy with bilateral bullous resection for unilateral spontaneous pneumothorax, with special reference to operative indications. J. Thorac. Cardiovasc. Surg., 96(4):615-620.

[13] Lang-Lazdunski, L., Chapuis, O., Bonnet, P.M., Pons, F., Jancovici, R., 2003. Videothoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term results. Ann. Thorac. Surg., 75(3):960-965.

[14] Liu, H.P., Yim, A.P., Izzat, M.B., Lin, P.J., Chang, C.H., 1999. Thoracoscopic surgery for spontaneous pneumothorax. World J. Surg., 23(11):1133-1136.

[15] Loubani, M., Lynch, V., 2000. Video assisted thoracoscopic bullectomy and acromycin pleurodesis: an effective treatment for spontaneous pneumothorax. Resp. Med., 94(9):888-890.

[16] Luh, S.P., Liu, H.P., 2006. Video-assisted thoracic surgery— the past, present status and the future. J. Zhejiang Univ. Sci. B, 7(2):118-128.

[17] Luh, S.P., Lee, Y.C., Lee, J.M., Lee, C.J., 1996. Videothoracoscopic treatment of spontaneous pneumothorax. Int. Surg., 81:336-338.

[18] Luh, S.P., Tsai, T.P., Chou, M.C., Yang, P.C., Lee, C.J., 2004. Video-assisted thoracic surgery for spontaneous pneumothorax: outcome of 189 cases. Int. Surg., 89:185-189.

[19] Luh, S.P., Chou, M.C., Wang, L.S., Chen, J.Y., Tsai, T.P., 2005. Video-assisted thoracoscopic surgery in the treatment of complicated parapneumonic effusions or empyemas, outcome of 234 patients. Chest, 127(4):1427-1432.

[20] Luh, S.P., Wu, T.C., Wang, Y.T., Tsao, T.C., Chen, J.Y., 2007. Experiences and benefits of positron emitted tomography-computed tomography (PET-CT) combined with video-assisted thoracoscopic surgery (VATS) in the diagnosis of Stage 1 sarcoidosis. J. Zhejiang Univ. Sci. B, 8(6):410-415.

[21] McCarthy, J.F., Lannon, D., McKenna, S., Wood, A.E., 1997. Video-assisted thoracic surgery (VATS) for spontaneous pneumothorax. Ir. J. Med. Sci., 166:217-219.

[22] Melvin, W.S., Krasna, M.J., McLaughlin, J.S., 1992. Thoracoscopic management of spontaneous pneumothorax. Chest, 102(6):1877-1879.

[23] Schoenenberger, R.A., Haefeli, W.E., Weiss, P., Ritz, R.F., 1991. Timing of invasive procedure in therapy for primary and secondary spontaneous pneumothorax. Arch. Surg., 126:764-766.

[24] Schramel, F.M., Sutedja, T.G., Braber, J.C., van Mourik, J.C., Postmus, P.E., 1996. Cost-effectiveness of video-assisted thoracoscopic surgery versus conservative treatment for first time or recurrent spontaneous pneumothorax. Eur. Respir. J., 9(9):1821-1825.

[25] Sihoe, A.D., Yim, A.P., Lee, T.W., Wan, S., Yuen, E.H., Wan, I.Y., Arifi, A.A., 2000. Can CT scanning be used to select patients with unilateral primary spontaneous pneumothorax for bilateral surgery? Chest, 118(2):380-383.

[26] Torresini, G., Vaccarili, M., Divisi, D., Crisci, R., 2001. Is video-assisted thoracic surgery justified at first spontaneous pneumothorax? Eur. J. Cardio-Thorac. Surg., 20(1):42-45.

[27] Watanabe, S., Sakasegawa, K., Kariatsumari, K., Suehiro, S., Kudama, T., Shimokawa, S., Sakata, R., 2004. Bilateral video-assisted thoracoscopic surgery in the supine position for primary spontaneous pneumothorax. Thorac. Cardiovasc. Surg., 52(1):42-44.

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