A clinical trial for preventing postoperative air leakage in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax

Objective Purpose This prospective randomized study was to explore the efficacy of different methods in preventing postoperative air leakage of video-assisted thoracoscopic(VATS) bullectomy for primary spontaneous pneumothorax. Methods The patients who underwent VATS bullectomy from January 2015 to March 2016 in Beijing Chao Yang Hospital were enrolled, and they were randomly assigned to experimental group and control group.The experimental group applied an absorbable polyglycolic acid(PGA) sleeve combining with an automatic stapler in the bullectomy.The control group resected the bullae using the automatic stapler alone.Covering the staple line with an absorbable polyglycolic acid sheet and pleural abrasion were performed in both groups. The baseline characteristics of the patients, postoperative air leakage, drainage tube removing time, postoperative hospital-stay, and postoperative complication were recorded. Results Finally, 123 patients were enrolled in the study, the experimental group and control group were 58 and 65 cases, respectively.There was no operative mortality in either group.Compared with the control group, the postoperative air leakage(0.53±0.99) days, chest tube drainage(2.98±1.03) days, postoperative hospital-stay(3.88±0.91) days in the experimental group were all significantly shorter.The rate of postoperative complications in the experimental group was(3.4%), of which one patient catched a pulmonary infection, the other one postoperative atelectasis. However, complications were developed in ten patients(15.4%) in the control group, which was significantly higher compared with the experimental group, including pulmonary infection five cases, postoperative atelectasis three cases, pleural effusion two cases. Conclusion The appliance of PGA sleeve in the operation for primary spontaneous pneumothorax could effectively prevent postoperative air leakage, as well as reduce the postoperative drainage tube removing time.Furthermore, the patient could recover more soon from the surgery, and have a shorter hospital-stay. Key words: Pneumothorax Video-assisted thoracoscopic surgery Postoperative air leakage Polyglycolic acid