Video-assisted thoracoscopic bullectomy and talc poudrage for spontaneous pneumothoraces: effect on short-term lung function.
OBJECTIVE
We measured lung function before and after video-assisted thoracoscopic apical bullectomy and talc poudrage in patients with spontaneous pneumothoraces.


METHODS
Seventy-two patients were prospectively followed up for 12 months. The indications for surgery were recurrent pneumothoraces (n = 58), bilateral pneumothoraces (n = 8), and persistent air leak (n = 6). There were 46 males and 26 females with mean age of 29 years (range 15-61 years). The results were analyzed using paired t tests.


RESULTS
There were no recurrences. There were 4 complications (5.6%): 1 wound infection, 1 case of pneumonia, and 2 persistent air leaks each lasting 1 week. There were no conversions to open surgery. Preoperative and 6-month pulmonary function test results were available on 41 patients, and 35 patients completed 12-month pulmonary function tests. Twelve-month values (mean percent ± SD) were as follows: Forced expiratory volume in 1 second fell from 95 ± 19 to 89 ± 16 (P = .02); forced expiratory volume in 1 second/forced vital capacity ratio was unchanged, 95 ± 12 versus 94 ± 13 (P = .9); total lung capacity fell from 106 ± 19 to 98 ± 12 (P = 0.002); vital capacity fell from 100 ± 22 to 96 ± 16 (P = .05); residual volume fell from 126 ± 32 to 107 ± 29 (P = .002); and diffusion capacity for carbon monoxide corrected for alveolar volume was unchanged, 88 ± 15 versus 91 ± 17 (P = .07). Flow rates and diffusion capacities were preserved, but lung volumes were slightly reduced at 1 year.


CONCLUSIONS
Video-assisted thoracoscopic apical bullectomy and talc poudrage is an effective treatment for spontaneous pneumothoraces with a low complication rate and recurrence rate and only minor changes in pulmonary function at 1 year.
Dubois
Luc
L
Division of Thoracic Surgery, Department of Surgery, The University of Western Ontario, London, Ontario, Canada.
Malthaner
Richard A
RA
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012129:Respiratory Function Tests; D013627:Talc / Q000627:therapeutic use*; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome
D013627:Talc