title: Videothoracoscopic silver nitrate pleurodesis for primary spontaneous pneumothorax: an alternative to pleurectomy and pleural abrasion?
abstract: BACKGROUND
  The optimal surgical management of primary spontaneous pneumothorax (PSP) is still controversial, especially in terms of the technique to be used. The aim of this paper was to report our experience of videothoracoscopic silver nitrate pleurodesis (VATSNP).
  
  
  METHODS
  Between 1995 and 2004, all the medical records of the patients who had undergone silver nitrate videothoracoscopic pleurodesis (SNVTP) were reviewed. All the patients had systematic prospective clinical and radiological follow-up at 1 month. The last 250 patients were retrospectively recontacted for long-term follow-up.
  
  
  RESULTS
  Six hundred and three patients underwent SNVP. No intra-operative death or major complication occurred during or after the procedures. Mean operating time was 40.2+/-10.7 min. The conversion to thoracotomy rate was 2.5%. Main postoperative complications were prolonged air leak (15.6%), partial residual pneumothorax (5.1%), pleural effusion (2.5%) and postoperative bleeding (2.0%). The follow-up was 100% complete 1 month after discharge; at 1 month, the recurrence rate was 0.5%. The last 250 patients were retrospectively recontacted with a mean follow-up of 2.9+/-2.3 years (184 patients). The long-term recurrence rate was 1.1%.
  
  
  CONCLUSIONS
  It is one of the first reports on the use of video-assisted thoracoscopic silver nitrate pleurodesis for PSP. We demonstrate safety and effectiveness of the procedure with long-term results comparable with standard open pleural abrasion or pleurectomy.
authors.affiliation: Department of Thoracic Surgery, Rangueil-Larrey University Hospital, 24 chemin de Pouvourville, TSA 30031, 31059 Toulouse Cedex 9, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Marcheix
authors.forename: Laurent
authors.initials: L
authors.lastname: Brouchet
authors.forename: Claire
authors.initials: C
authors.lastname: Renaud
authors.forename: Yoan
authors.initials: Y
authors.lastname: Lamarche
authors.forename: Antoine
authors.initials: A
authors.lastname: Mugniot
authors.forename: Vincent
authors.initials: V
authors.lastname: Benouaich
authors.forename: Jean
authors.initials: J
authors.lastname: Berjaud
authors.forename: Marcel
authors.initials: M
authors.lastname: Dahan
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D018700:Pleurodesis / Q000379:methods*; D011030:Pneumothorax / Q000601:surgery / Q000628:therapy*; D011182:Postoperative Care / Q000379:methods; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012835:Silver Nitrate / Q000008:administration & dosage*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D012835:Silver Nitrate