This study was performed to know the safety and efficacy of limited min-ithoracotomy, which is a new method of operative procedure modified from minithoracotomy.

Eleven consecutive patients who underwent a limited minithoracotomy for the treatment of primary spontaneous pneumothorax from Jan.1.1994 to Dec.31.1995 were reviewed with medical records, laboratory and x-ray findings, and followed by reaching patient by phone or interviewing at the outpatient department.

The indication of these consecutive 11 patients were recurrent pneumothrorax 4 cases, continuous air leaking 7 cases, and visible bullae on chest x-ray or chest CT 2 cases. There were 12 limited minithoracotomies in 11 patients including on bilateral limited minithoracotomy. Average operative time was 54 minutes. There was no conversion to extended thoracotomy from limited minithoracotomy. No postoperative bleeding or infection was oberved. One patient showed prolonged air leak after operation who had multiple bullae resected from his left upper and lower lung, and was discharged 18 days after operation with good condition. Another patient experienced air sucking during chest tube removal on 4th postoperative day and discharged on 9th day after operation. Other patients wre discharged within 5th postoperative day. Average hospital stay after operation was 5.4 days. All eleven patients were followed up for 12±7.7months. There was no recurrences of pneumothorax.

These results suggest that limited minithoracotomy is choice of treatment when primary spontaneous pneumothorax patient requires surgery.

Surgical closure of patent ductus arterious(PDA) by lateral thoracotomy is considered as a standard therapy. But large incision, muscle cutting and chest pain are problematic. So I used two less invasive techniques : minithoracotomy and video-assisted thoracoscopic surgery. I tried to compare the results of them.

I reviewed the clinical records and operative reports of 22 children patients who were treated surgically between Jan. 19996 and Dec. 1996. Ten patients underwent Minithoracotomy(MT) and twelve patients Video-assisted thoracoscopic surgery(VATS). All of them were used tithanium clipping for closure of PDA.

Both groups were similar in age, body weight, Echocardiographically estimated size of PDA and Qp/Qs. All procedures were performed uneventfully. Operative time averaged 104±26 minutes for MT versus 96±31 minutes for VATS. Mean hospital stay was 7.2±1.7 days for MT and 4.6±1.2 days for VATS(p<0.05}. Postoperative hoarseness was occured in one patient(MT group) but was transient. There was no case with residual shunt confirmed by echocardiography.

Minithoracotomy and Video-assisted thoracoscopic surgery were as effective as lateral thoracotomy for closure of patent ductus arteriosus. Operative times were similar in two techniques but hospital stays were shorter in VATS group. Both MT and VATS techniques are effective and less invasive but I advocate VATS technique is more beneficial in terms of hospital stay and cosmetic aspect.