PT  - JOURNAL ARTICLE
AU  - FM Schramel
AU  - TG Sutedja
AU  - JC Braber
AU  - JC van Mourik
AU  - PE Postmus
TI  - Cost-effectiveness of video-assisted thoracoscopic surgery versus conservative treatment for first time or recurrent spontaneous pneumothorax
AID  - 10.1183/09031936.96.09091821
DP  - 1996 Sep 01
TA  - European Respiratory Journal
PG  - 1821--1825
VI  - 9
IP  - 9
4099  - http://erj.ersjournals.com/content/9/9/1821.short
4100  - http://erj.ersjournals.com/content/9/9/1821.full
SO  - Eur Respir J1996 Sep 01; 9
AB  - The aim of this study was to analyse differences in efficacy and costs in treating first time or recurrent spontaneous pneumothorax by conservative therapy (pleural drainage or observation) and video-assisted thoracoscopic surgery (VATS). Retrospectively, 112 patients treated by conservative therapy during 1985-1989 (Period 1) were compared with 97 patients treated by VATS during 1991-1994 (Period 2). Mean follow-up time in each period was more than 2 yrs. Patients in both periods had comparable clinical characteristics. Irrespective of first time or recurrent spontaneous pneumothorax at presentation, drainage and hospitalization times were longer, and complication and recurrence rates were higher in Period 1. When costs due to the waiting time before VATS were excluded, the total costs in Period 1 were higher than in Period 2. Video-assisted thoracoscopic surgery is more effective in treating patients with first time or recurrent spontaneous pneumothorax, with less morbidity and total costs compared to conservative therapy. In view of cost-effectiveness, we feel that a different management of first time or recurrent spontaneous pneumothorax is not justified.