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New Electroablation Technique Following the First-Line Stapling Method for Thoracoscopic Treatment of Primary Spontaneous Pneumothorax^*

^* From the Thoracic Surgery Study Group of Osaka University, Osaka, Japan.

Correspondence to: Noriyoshi Sawabata MD, FCCP, Division of Surgery, Toneyama National Hospital, 5–1-1 Toneyama, Toyonaka, Osaka 560-8552 Japan; e-mail: nori{at}toneyama.hosp.go.jp

Study objectives: A new tip for the electroablation of pneumocysts was examined clinically as a second-line method for stapled resection of pneumocysts during video-assisted thoracoscopic surgery (VATS).

Design: A trial to assess feasibility.

Settings: National referral hospitals.

Patients: One hundred seven patients were studied, of whom 99 patients were eligible for the study (85 men and 14 women; age range, 15 to 69 years; median age, 23 years), who had undergone VATS for primary spontaneous pneumothorax between July 1996 and June 1998. Apical pneumocysts were resected employing staplers, and residual pneumocysts, if present, were electroablated employing a new tip for the electrosurgery unit (ball shape, 8 mm in diameter, and made of stainless steel).

Measurements and results: Thirty-three patients (33%) underwent electroablation only for small (< 2 cm in diameter) pneumocysts (group S), and 11 patients (11%) underwent electroablation for large ( 2 cm in diameter) pneumocysts (group L). The remaining 55 patients (56%) did not undergo electroablation because there were no residual pneumocysts (group N). There were no complications during surgery. The duration of the operation was significantly shorter (about 20 min on average) for group N, but there was no significant difference in the amount of blood loss, the number of applied staples, the duration of drainage, and the duration of hospital stay. Group S achieved a 100% relapse-free rate (33 of 33 patients), group L achieved a 64% relapse-free rate (7 of 11 patients), and group N achieved an 89% relapse-free rate (49 of 55 patients) [group S vs group N, p = 0.08; group L vs group N, p = 0.001; and group S vs group L, p = 0.002].

Conclusion: Electroablation with the M-tip is feasible as a second-line method for the treatment of small pneumocysts following the stapling technique during VATS.

Key Words: ablation • bulla • electrosurgical unit • spontaneous pneumothorax • video-assisted thoracoscopic surgery

This article has been cited by other articles:

				N. Sawabata, S.-I. Takeda, M. Inoue, M. Koma, T. Tokunaga, and H. Maeda M-tip electro-ablation of pneumo-cysts for treatment of spontaneous pneumothorax as a secondary method to stapling: a confirmation study Interactive CardioVascular and Thoracic Surgery, December 1, 2005; 4(6): 614 - 617. [Abstract] [Full Text] [PDF]