Thorac Cardiovasc Surg 2008; 56(4): 217-220
DOI: 10.1055/s-2007-989366
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Staple Line Covering Procedure after Thoracoscopic Bullectomy for the Management of Primary Spontaneous Pneumothorax

S. Cho1 , D. M. Huh2 , B. H. Kim2 , S. Lee3 , O. C. Kwon3 , W. S. Ahn3 , S. Jheon1
  • 1Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
  • 2Department of Thoracic Surgery, Daegu Fatima Hospital, Daegu, Republic of Korea
  • 3Department of Thoracic and Cardiovascular Surgery, Catholic University of Daegu, Daegu, Republic of Korea
Further Information

Publication History

received July 23, 2007

Publication Date:
15 May 2008 (online)


Background: Thoracoscopic bullectomy together with a pleural adhesive procedure is generally accepted as the standard for the definitive treatment of primary spontaneous pneumothorax (PSP). The purpose of this study was to evaluate whether the results of a thoracoscopic bullectomy followed by coverage of the staple line with cellulose mesh and fibrin glue could be comparable with those of adhesive procedures described in the literature. Methods: Between May 2000 and February 2003, we performed 227 thoracoscopic surgeries on 219 patients with PSP using a single technique. After the bullectomy, the staple line was covered with cellulose mesh and fibrin glue. The postoperative status was evaluated with a mean follow-up of 46 months. Results: The mean patient age was 24.3 years and 90.9 % of the 219 patients were male. Recurrent pneumothorax (37.4 %) was the most common operative indication, followed by persistent air leakage of more than 5 days (28.2 %). The mean duration of postoperative chest tube drainage was 1.6 days and the mean postoperative hospital stay was 3.8 days. Six patients experienced surgical complications (2.2 %); there was air leakage of more than 3 days in two cases, a small apical dead space in one case, a fever-associated wound problem in one case, and a reoperation due to air leakage of more than 7 days in two cases. Eleven patients (4.8 %) suffered a recurrence of pneumothorax during the follow-up period. Of these, nine cases required readmission and three (1.3 %) of these cases required a reoperation. Conclusions: Given the nature of a meticulous thoracoscopic bullectomy followed by coverage with cellulose mesh and fibrin glue, good surgical results can be expected without the need for a pleural adhesive procedure.


Dr. Sanghoon Jheon

Department of Thoracic and Cardiovascular Surgery
Seoul National University Bundang Hospital

300. Gumi-dong

Seongnam-si Gyeonggi-do

463-707 Korea

Phone: + 82 3 17 87 71 33

Fax: + 82 3 17 87 40 50