Thoracoscopic management of primary spontaneous pneumothorax.
BACKGROUND
Video-assisted thoracoscopic surgery (VATS) is the preferred option for the surgical management of primary spontaneous pneumothorax (PSP).


OBJECTIVE
To evaluate the role of thoracoscopic blebectomy with and without chemical pleurodesis.


METHODS
A retrospective study was performed on 113 consecutive cases carried out in one unit. RESULTS; One hundred and thirteen VATS procedures were performed on 108 patients. The mean age was 23 years (range 14-45). The male to female ratio was 82:26. Recurrent pneumothorax was the indication for surgery in 80%. Conversion to an open procedure was required in 10 cases (9%), most commonly due to severe adhesions. Successful endoscopic blebectomy was performed in 98 cases (87%), 48 of which had an additional chemical pleurodesis. Follow-up is currently to a mean of 28 months. Recurrence has occurred in eight cases, including only three in the group managed with additional chemical pleurodesis (6.25%).


CONCLUSIONS
VATS with blebectomy and chemical pleurodesis is a safe and effective procedure in the management of PSP.
Connolly
S S
SS
Thoracic Surgery Unit, St Vincent's University Hospital, Dublin, Ireland.
Hurson
C
C
Lynch
V
V
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018700:Pleurodesis; D011030:Pneumothorax / Q000601:surgery*; D011500:Protein Synthesis Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D013752:Tetracycline / Q000627:therapeutic use; D020775:Thoracic Surgery, Video-Assisted
D011500:Protein Synthesis Inhibitors; D013752:Tetracycline