Treatment of Aged Spontaneous Pneumothorax with Video Assisted Thoracoscope Surgery (VATS),VATS Assisted Small Incision Surgery and Thoracotomy

[Objective] To discuss the treatment efficiency of thoracoscope surgery (VATS), VATS assisted small incision surgery (VATS+SIS) and thoracotomy (TS) on spontaneous pneumothorax of aged patients, and to find out the most reasonable surgical method for the disease. [Method] 45 patients with aged spontaneous pneumothorax were randomly assigned to receive VATS, VATS+SIS, TS, which were defined as groups A, B and C respectively. The perioperative treatment efficiency, pulmonary function and serum levels of IL-1 and TNF-α were compared among the three groups. [Result] All cases recovered with no mortality. Patients of group A and B need less thoracic drainage duration, analgesics, hospitalization and perioperative blood loss, when compared with group C (P 0.05), with no difference between group A and B (P 0.05). Both serum IL-1 and TNF-α of group C increased significantly during 2 days after operation (P 0.05) against group A and B, but no difference between group A and B. Apparent significance existed among three groups on the operative duration (P 0.05). Patients' post-operative pulmonary function recovered earlier in group A and B in 2 weeks than group C (P 0.05), but no such significance existed among three groups two more weeks later (P 0.05). [Conclusion] VATS+SIS is the most reasonable surgery for the aged spontaneous pneumothorax who has other complication, especially for the patients complicated with cardiopulmonary dysfunction.