A comparison of axillary thoracotomy versus video-assisted thoracoscopic surgery in the surgical treatment of primary spontaneous pneumothorax

Background: This study aims to compare the results of video-assisted thoracoscopic surgery and axillary thoracotomy in the surgical treatment of primary spontaneous pneumothorax. Methods: Between January 2009 and December 2015, a total of 199 patients (178 males, 21 females; mean age 21.3 +/- 7.1 years; range 13 to 35 years) with primary spontaneous pneumothorax who were operated at Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Thoracic Surgery and Kadikoy and Kozyatagi Acibadem hospitals were retrospectively analyzed. Of these patients, 48 underwent axillary thoracotomy, wedge resection, apical pleurectomy, and tissue adhesives, while 151 were administered videoassisted thoracoscopic surgery, wedge resection, apical pleurectomy, and tissue adhesives. Both groups were compared in terms of age, gender, the amount of long-term analgesic use, duration of surgery, length of hospitalization, recurrence, complication, and mortality rates. Results: The patients were followed for one year. No mortality was observed in any patient. There was no significant difference in the age and gender distributions of the patients, postoperative length of hospital stay, recurrence rates, and complication rates according to the type of operation. However, the duration of operation was longer in the video-assisted thoracoscopic surgery patients. Conclusion: Video-assisted thoracoscopic surgery is associated with less pain and higher patient satisfaction and allows returning to daily activities in a shorter time period. Based on our study results, we suggest that video-assisted thoracoscopic surgery is more suitable, compared to axillary thoracotomy, owing to its advantages, such as being less invasive and providing a better angle of view.