Ligation versus stapling in video-assisted thoracoscopic (VATS) bullectomy; early outcome of a low cost technqiue

Abstract
Background
Spontaneous pneumothorax is thoracic condition, with annual incidence of 7 to 9 cases per 100,000 people. Most of thoracic surgeons prefer minimally invasive method that uses staplers to resect bullous parenchyma, but this technique is costly. Now, the problem of rising health care costs is faced by all countries all over the world. As result, preventing use of disposable consumables in video-assisted thoracic surgery (VATS) will aid in cost control.
In our study, we described a new cheap technique which was VATS ligation of bullae by silk ligature and we compared it to standard technique of using staplers in VATS bullectomy.

Aim of Work
We aimed to investigate the results of VATS ligation of bullae by silk ligature in comparison to using staplers in VATS bullectomy.

Patient & techniques
This was retrospective research done on 120 studied cases at cardiothoracic surgery, 2nd Affiliated Hospital, Harbin Medical University, China and Assiut University Hospital, Egypt from March 2020 to December 2021.

Results
We retrospectively investigate data of 120 patients and there was no variation in patient characteristics among VATS bullectomy using staplers and VATS bullae ligation. Air leak duration and post-operative drainage were statistically significant higher in VATS bullectomy using staplers than bullae ligation.
Hospital stay duration (mean = 3.800 ± 1.070 vs 4.917 ± 2.794) and complications were statistically significant higher in VATS bullectomy using staplers than thoracoscopic bullae ligation.

Conclusion
Treatment of spontaneous pneumothorax by thoracoscopic ligation of bullae by silk ligature is comparable to VATS bullectomy using staplers in short-term results and offers less complications and better economic results.