Abstract：
The postoperative recurrence rate after thoracoscopic bullectomy for primary spontaneous pneumothorax (PSP) is not satisfactory. This retrospective study was conducted to elucidate an effective technique for improving the postoperative recurrence rate.
The present study included 373 patients who underwent thoracoscopic bullectomy for PSP at three hospitals from January 2013 to May 2020. We compared the recurrence rate according to two methods that were used to cover the staple line after thoracoscopic bullectomy. Group A (146 patients) was treated with an absorbable polyglycolic acid (PGA) sheet plus fibrin glue and oxidised regenerated cellulose (ORC). Group B (227 patients) was treated with ORC alone.
There was no significant difference in preoperative characteristics of the patients. The postoperative recurrence rate of pneumothorax was 3.4% (5/146) in Group A and 17.2% (39/227) in Group B, respectively. Among 23 patients (Group A, n=3 and Group B, n=20) who received reoperation for recurrent pneumothorax, the site of recurrence was around the stapler line of the first operation in 1 of 5 (20%) patients in Group A and 28 of 39 (71.8%) patients in Group B. The 1-year recurrence-free rate was 97.4% (median follow-up period, 73 days (range, 2-3952 days)) in Group A and 80.9% (median follow-up period, 71 days (range 2-2648 days)) in Group B.
Coverage with a PGA sheet may prevent the postoperative recurrence of PSP. A large-scale prospective randomised study should be conducted to clarify the most effective treatment for PSP.
The present study included 373 patients who underwent thoracoscopic bullectomy for PSP at three hospitals from January 2013 to May 2020. We compared the recurrence rate according to two methods that were used to cover the staple line after thoracoscopic bullectomy. Group A (146 patients) was treated with an absorbable polyglycolic acid (PGA) sheet plus fibrin glue and oxidised regenerated cellulose (ORC). Group B (227 patients) was treated with ORC alone.
There was no significant difference in preoperative characteristics of the patients. The postoperative recurrence rate of pneumothorax was 3.4% (5/146) in Group A and 17.2% (39/227) in Group B, respectively. Among 23 patients (Group A, n=3 and Group B, n=20) who received reoperation for recurrent pneumothorax, the site of recurrence was around the stapler line of the first operation in 1 of 5 (20%) patients in Group A and 28 of 39 (71.8%) patients in Group B. The 1-year recurrence-free rate was 97.4% (median follow-up period, 73 days (range, 2-3952 days)) in Group A and 80.9% (median follow-up period, 71 days (range 2-2648 days)) in Group B.
Coverage with a PGA sheet may prevent the postoperative recurrence of PSP. A large-scale prospective randomised study should be conducted to clarify the most effective treatment for PSP.
摘要：
胸腔镜下原发性自发性气胸（PSP）的术后复发率不理想。这项回顾性研究旨在阐明提高术后复发率的有效技术。
本研究纳入了2013年1月至2020年5月在三家医院接受胸腔镜PSP大泡切除术的373例患者。我们比较了胸腔镜肺大泡切除术后两种用于覆盖钉线的方法的复发率。A组（146例患者）接受了可吸收的聚乙醇酸（PGA）片加上纤维蛋白胶和氧化再生纤维素（ORC）的治疗。B组(227例患者)单独用ORC治疗。
患者术前特征无显著差异。术后气胸复发率A组为3.4%(5/146),B组为17.2%(39/227),分别。在23例患者中（A组，n=3，B组，n=20）因复发性气胸而接受再次手术，A组5例患者中有1例（20％）复发，B组39例患者中有28例（71.8％）复发部位在首次手术的吻合器线附近。1年无复发率为97.4％（中位随访期，73天(范围，2-3952天））在A组中，占80.9%（中位随访期，B组的71天（范围2-2648天））。
用PGA片覆盖可以防止PSP的术后复发。应进行大规模的前瞻性随机研究，以阐明PSP最有效的治疗方法。
本研究纳入了2013年1月至2020年5月在三家医院接受胸腔镜PSP大泡切除术的373例患者。我们比较了胸腔镜肺大泡切除术后两种用于覆盖钉线的方法的复发率。A组（146例患者）接受了可吸收的聚乙醇酸（PGA）片加上纤维蛋白胶和氧化再生纤维素（ORC）的治疗。B组(227例患者)单独用ORC治疗。
患者术前特征无显著差异。术后气胸复发率A组为3.4%(5/146),B组为17.2%(39/227),分别。在23例患者中（A组，n=3，B组，n=20）因复发性气胸而接受再次手术，A组5例患者中有1例（20％）复发，B组39例患者中有28例（71.8％）复发部位在首次手术的吻合器线附近。1年无复发率为97.4％（中位随访期，73天(范围，2-3952天））在A组中，占80.9%（中位随访期，B组的71天（范围2-2648天））。
用PGA片覆盖可以防止PSP的术后复发。应进行大规模的前瞻性随机研究，以阐明PSP最有效的治疗方法。
