Surgical pleurodesis for Vanderschueren's stage III primary spontaneous pneumothorax.
The aim of the present study was to determine the impact of various pleurodesis procedures on post-operative morbidity and late recurrence rate after surgical treatment of Vanderschueren's stage III primary spontaneous pneumothorax. Between January 2001 and June 2004, 208 consecutive patients (169 male and 39 female; mean (range) age 25 (12-39) yrs) were submitted to 220 video-assisted thoracoscopic surgical procedures for primary spontaneous pneumothorax. All patients underwent apical lung resection; 112 were assigned at random to mechanical pleural abrasion (group A) and 108 to apical pleurectomy (group B). The two groups of patients showed similar characteristics. No intra- or post-operative deaths occurred. Post-operative morbidity was 6.25% for group A and 12.9% for group B; the two groups exhibited a similar persistent post-operative air leak rate (5.3% in group A and 5.5% in group B), whereas haemothorax was significantly more frequent after apical pleurectomy (eight (7.4%) cases) than after pleural abrasion (one (0.9%) case). The mean duration of follow-up was 46 (24-66) months. Late recurrence occurred in five cases (4.6%) after apical pleurectomy, and in seven (6.2%) after mechanical pleural abrasion. Mechanical pleural abrasion by video-assisted thoracoscopic surgery is safer than apical pleurectomy in the treatment of primary spontaneous pneumothorax. No differences in late recurrence rate were observed between the two procedures.
Rena
O
O
Thoracic Surgery Unit, University A. Avogadro, Via Frasconi, 14, 28100 Novara, Italy. ottaviorena@libero.it
Massera
F
F
Papalia
E
E
Della Pona
C
C
Robustellini
M
M
Casadio
C
C
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D018700:Pleurodesis / Q000379:methods*; D011030:Pneumothorax / Q000601:surgery*; D055502:Secondary Prevention; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods