Vicryl Mesh Coverage Reduced Recurrence After Bullectomy for Primary Spontaneous Pneumothorax.

Although thoracoscopic stapled bullectomy is a standard procedure for primary spontaneous pneumothorax (PSP), the postoperative recurrence rate is high. We investigated whether using a Vicryl (Ethicon, Somerville, NJ) mesh to cover the staple line after bullectomy reduces the postoperative recurrence rate. Our single-blind, parallel-group, prospective, randomized controlled trial at 2 medical centers in Taiwan studied patients with PSP who were aged 15 to 50 years and required thoracoscopic bullectomy. On the day of operation, patients were randomly assigned (1:1) to receive Vicryl mesh (mesh group) or not (control group) after thoracoscopic bullectomy with linear stapling and mechanical apical pleural abrasion. Randomization was achieved using computer-generated random numbers in sealed envelopes. Our primary end point was the pneumothorax recurrence rate within 1 year after the operation (clinicaltrials.gov number, NCT01848860.) RESULTS: Between June 2013 and March 2016, 102 patients were assigned to the mesh group and 102 to the control group. Within 1 year after operation, recurrent pneumothorax was diagnosed in 3 patients (2.9%) in the mesh group compared with 16 (15.7%) in the control group (P = .005). The short-term postoperative results and hospitalization duration were comparable between the groups. For thoracoscopic bullectomy with linear stapling and mechanical apical pleural abrasion, the use of a Vicryl mesh to cover the staple line is effective for reducing the postoperative recurrence of pneumothorax. Vicryl mesh coverage can be considered an optimal adjunct to the standard surgical procedure for PSP. Copyright © 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Citation

Hsao-Hsun Hsu, Yun-Hen Liu, Hsuan-Yu Chen, Pei-Hsing Chen, Ke-Cheng Chen, Ming-Ju Hsieh, Mong-Wei Lin, Shuenn-Wen Kuo, Pei-Ming Huang, Yin-Kai Chao, Ching-Feng Wu, Ching-Yang Wu, Chien-Hung Chiu, Wei-Hsun Chen, Chih-Tsung Wen, Chao-Yu Liu, Yi-Cheng Wu, Jin-Shing Chen. Vicryl Mesh Coverage Reduced Recurrence After Bullectomy for Primary Spontaneous Pneumothorax. The Annals of thoracic surgery. 2021 Nov;112(5):1609-1615

PMID: 33279544

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