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M-tip electro-ablation of pneumo-cysts for treatment of spontaneous pneumothorax as a secondary method to stapling: a confirmation study

Division of Surgery, Toneyama National Hospital, 5-1-1, Toneyama, Toyonaka, Osaka 560-8552, Japan. Department of Surgery (E1), Osaka University Graduate School of Medicine, Osaka Japan

*Corresponding author. Tel.: +81-6-6879-3152; fax: +81-6-6879-3164.

E-mail address: sawabata{at}surg1.med.osaka-u.ac.jp (N. Sawabata).

Background: We recently established new guidelines for our electro-ablation technique, which has been shown to be a ubiquitous, easy, and cost effective method secondary to stapled resection of pneumo-cysts for the treatment of pneumothorax. The present study was conducted as a confirmation of the effectiveness of this technique. Patients and methods: Between July 1998 and June 2003, 164 consecutive patients with spontaneous pneumothorax underwent surgery. Dependent lesions were resected using staplers. If found, residual lesions were ablated using M-tip electro-ablation (Group M). When the ablated pneumo-cysts were greater than 2 cm in diameter, pleural treatment was carried out by covering the surface with absorbable mesh sheets (Group L). Results: There were 7 cases (4.2%) of relapse of spontaneous pneumothorax and each underwent another operation due to the relapse. None of the lesions in the relapse cases received electro-ablation in the first operation. Relapse-free cases were 97/103 (94%) in Group N (no ablation group), 48/49 (98%) in Group M, and 12/12 (100%) in Group L (P=0.4). Comments: Our results demonstrated the safety and efficacy of our M-tip electro-ablation technique for pneumo-cysts as a secondary method to stapling. We considered that it was feasible for the treatment of spontaneous pneumothorax.

Key Words: Spontaneous pneumothorax; Ablation; Stapler; Electro-surgical unit