Study objectives: A new tip for the electroablation of
pneumocysts was examined clinically as a second-line method for stapled
resection of pneumocysts during video-assisted thoracoscopic surgery
Design: A trial to assess feasibility.
Settings: National referral hospitals.
Patients: One hundred seven patients were studied, of whom
99 patients were eligible for the study (85 men and 14 women; age
range, 15 to 69 years; median age, 23 years), who had undergone VATS
for primary spontaneous pneumothorax between July 1996 and June 1998.
Apical pneumocysts were resected employing staplers, and residual
pneumocysts, if present, were electroablated employing a new tip for
the electrosurgery unit (ball shape, 8 mm in diameter, and made of
Measurements and results:
Thirty-three patients (33%) underwent electroablation only for small
(< 2 cm in diameter) pneumocysts (group S), and 11 patients (11%)
underwent electroablation for large (≥ 2 cm in diameter) pneumocysts
(group L). The remaining 55 patients (56%) did not undergo
electroablation because there were no residual pneumocysts (group N).
There were no complications during surgery. The duration of the
operation was significantly shorter (about 20 min on average) for group
N, but there was no significant difference in the amount of blood loss,
the number of applied staples, the duration of drainage, and the
duration of hospital stay. Group S achieved a 100% relapse-free rate
(33 of 33 patients), group L achieved a 64% relapse-free rate (7 of 11
patients), and group N achieved an 89% relapse-free rate (49 of 55
patients) [group S vs group N, p = 0.08; group L vs group N,
p = 0.001; and group S vs group L, p = 0.002].
Conclusion: Electroablation with the M-tip is feasible as a
second-line method for the treatment of small pneumocysts following the
stapling technique during VATS.