Abstract
Background: Several video-assisted techniques have been used to treat primary spontaneous pneumothorax (PSP). The aim of this study was to evaluate the results of thoracoscopic pleural abrasion for PSP. Methods: From 1991 to 2003, 185 consecutive patients, 143 male and 42 female, aged 15 to 60 years (average 31.6) underwent thoracoscopic pleural abrasion for PSP. The indications for surgery were as follows: a first episode with persistent air leak in 33 patients (17.9%), a recurrent ipsilateral pneumothorax in 122 patients (65.9%), a previous contralateral pneumothorax in 23 patients (12.4%), and recurrence after surgical treatment in seven patients (3.8%). Bullae were resected in 163 patients (88.1%). Mechanical pleural abrasion was performed in all cases. Results: There were no deaths. Intraoperative hemorrhage occurred in three patients. It was controlled via thoracotomy in one patient and via thoracoscopy in two patients. The postoperative complication rate was 8.1% (15/185). Complications included prolonged air leak in eight patients (4.3%), pleural effusion in two (1.1%), extrapleural hematoma in one (0.5%), chest wall infection in one (0.5%), atelectasis in one (0.5%), and hemorrhage in two (1.1%). Postoperative hospital stay ranged between 2 and 17 days (mean, 5). Mean duration of drainage was 3.8 days (range; 1–16). Postoperatively, 111 patients were contacted, with a mean follow-up of 36.5 months. Four of them had a recurrence (3.6%) that did not require reoperation. Conclusion: Thoracoscopic pleural abrasion associated with bullae resection is a safe and efficient treatment for PSP. Results remain stable in the long term.
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References
A Ayed H AI-Din (2000) ArticleTitleThe results of thoracoscopic surgery for primary spontaneous pneumothorax. Chest 118 235–238 Occurrence Handle10.1378/chest.118.1.235 Occurrence Handle1:STN:280:DC%2BD3czpsVKrsw%3D%3D Occurrence Handle10893385
M Bauman C Strange J Heffner R Light T Kirby J Klein J Luketich E Panacek S Sahn (2001) ArticleTitleManagement of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 119 590–602 Occurrence Handle10.1378/chest.119.2.590 Occurrence Handle11171742
P Bertrand J Regnard L Spaggiari J Levi P Magdeleinat L Guibert P Levasseur (1996) ArticleTitleImmediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Ann Thorac Surg 61 1641–1645 Occurrence Handle10.1016/0003-4975(96)00190-7 Occurrence Handle1:STN:280:BymB38ritlc%3D Occurrence Handle8651762
M Bresticker J Oba J LoCicero R Greene (1993) ArticleTitleOptimal pleurodesis: a comparison study. Ann Thorac Surg 55 364–367 Occurrence Handle1:STN:280:ByyC2MbhvFI%3D Occurrence Handle8431042
G Cardillo F Facciolo R Giunti R Gasparri M Lopergolo R Orsetti M Martelli (2000) ArticleTitleVideothoracoscopic treatment of primary spontaneous pneumothorax: a 6-year experience. Ann Thorac Surg 69 357–362 Occurrence Handle10.1016/S0003-4975(99)01299-0 Occurrence Handle1:STN:280:DC%2BD3c7pslOisg%3D%3D Occurrence Handle10735663
G Cardillo F Facciolo M Regal L Carbone F Corzani A Ricci M Martelli (2001) ArticleTitleRecurrences following videothoracoscopic treatment of primary spontaneous pneumothorax: the role of redo-videothoracoscopy. Eur J Cardiothorac Surg 19 396–399 Occurrence Handle10.1016/S1010-7940(01)00611-X Occurrence Handle1:STN:280:DC%2BD3MvitlSnsQ%3D%3D Occurrence Handle11306302
C Casadio O Rena R Giobbe G Maggi (2001) ArticleTitlePrimary spontaneous pneumothorax: is video-assisted thoracoscopy stapler resection with pleural abrasion the gold-standard? Eur J Cardiothorac Surg 20 897–898 Occurrence Handle10.1016/S1010-7940(01)00892-2 Occurrence Handle1:STN:280:DC%2BD3MngvVGisg%3D%3D Occurrence Handle11683149
H Colt V Russack Y Chiu R Konopka P Chiles C Pedersen D Kapelanski (1997) ArticleTitleA comparison of thoracoscopic talc insufflation, slurry, and mechanical abrasion pleurodesis. Chest 111 442–448 Occurrence Handle1:STN:280:ByiC1MvlsFI%3D Occurrence Handle9041994
F Gebhard H Becher H Gerngross U Bruckner (1996) ArticleTitleReduced inflammatory response in minimal invasive surgery of pneumothorax. Arch Surg 131 1079–1082 Occurrence Handle1:STN:280:ByiD3M%2Foslc%3D Occurrence Handle8857906
D Gupta A Hansell T Nichols T Duong J Ayres D Strachan (2000) ArticleTitleEpidemiology of pneumothorax in England. Thorax 55 666–671 Occurrence Handle10.1136/thorax.55.8.666 Occurrence Handle1:STN:280:DC%2BD3czpvFWnsg%3D%3D Occurrence Handle10899243
R Hatz M Kaps G Meimarakis F Loehe C Müller H Fürst (2000) ArticleTitleLong-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax. Ann Thorac Surg 70 253–257 Occurrence Handle10.1016/S0003-4975(00)01411-9 Occurrence Handle1:STN:280:DC%2BD3cvgvVKjtg%3D%3D Occurrence Handle10921718
M Hayland A Ashrafi A Crepeau R Mehran (2001) ArticleTitleIs video-assisted thoracoscopic surgery superior to limited axillary thoracotomy in the management of spontaneous pneumothorax? Can Respir J 8 339–343 Occurrence Handle11694914
H Horio H Nomori G Fuyuno R Kobayashi K Suemasu (1998) ArticleTitleLimited axillary thoracotomy vs video-assisted thoracoscopic surgery for spontaneous pneumothorax. Surg Endosc 12 1155–1158 Occurrence Handle10.1007/s004649900805 Occurrence Handle1:STN:280:DyaK1czosVCltA%3D%3D Occurrence Handle9716772
K Kim H Kook J Han J Kim Y Won SS Choi (1996) ArticleTitleTransaxillary minithoracotomy versus video-assisted thoracic surgery for spontaneous pneumothorax. Ann Thorac Surg 61 1510–1512 Occurrence Handle10.1016/0003-4975(96)00113-0 Occurrence Handle1:STN:280:BymB3c7nslI%3D Occurrence Handle8633968
L Lang-Lazdunski O Chapuis P Bonnet F Pons R Jancovici (2003) ArticleTitleVideothoracoscopic bleb excision and pleual abrasion for the treatment of primary spontaneous pneumothorax: long-term results. Ann Thorac Surg 75 960–965 Occurrence Handle10.1016/S0003-4975(02)04544-7 Occurrence Handle12645724
J Levi P Kleinmann M Riquet B Debesse (1990) ArticleTitlePercutaneous parietal pleurectomy for recurrent spontaneous pneumothorax. Lancet 936 1577–1578 Occurrence Handle10.1016/0140-6736(90)93351-O
A Maier U Anegg H Renner F Tomaselli B Fell R Lunzer O Sankin H Pinter G Friehs F Smolle-Jüttner (2000) ArticleTitleFour-year experience with pleural abrasion using a rotating brush during video-assisted thoracoscopy. Surg Endosc 14 75–78 Occurrence Handle10.1007/s004649900016 Occurrence Handle1:STN:280:DC%2BD3c7hs12nsQ%3D%3D Occurrence Handle10653242
G Massard P Thomas J Wihlm (1998) ArticleTitleMinimally invasive management for first and recurrent pneumothorax. Ann Thorac Surg 66 592–599 Occurrence Handle10.1016/S0003-4975(98)00621-3 Occurrence Handle1:STN:280:DyaK1czptFaguw%3D%3D Occurrence Handle9725423
K Naunheim M Mack S Hazelrigg (1995) ArticleTitleSafety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax. J Thorac Cardiovasc Surg 109 1198–1204 Occurrence Handle1:STN:280:ByqB1MrjtlA%3D Occurrence Handle7776683
K Ohno S Miyoshi M Minami A Akashi H Maeda K Nakagawa A Matsumura K Nakamura H Matsuda S Ohashi (2000) ArticleTitleIpsilateral recurrence frequency after video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. Jpn J Thorac Cardiovasc Surg 48 757–760
B Passlick C Born K Häussinger O Thetter (1998) ArticleTitleEfficiency of video-assisted thoracic surgery for primary and secondary spontaneous pneumothorax. Ann Thorac Surg 65 324–327 Occurrence Handle10.1016/S0003-4975(97)01128-4 Occurrence Handle1:STN:280:DyaK1c7ktlOltg%3D%3D Occurrence Handle9485222
B Passlick C Born W Sienel O Thetter (2001) ArticleTitleIncidence of chronic pain after minimal-invasive surgery for spontaneous pneumothorax. Eur J Cardiothorac Surg 19 355–359 Occurrence Handle10.1016/S1010-7940(01)00568-1 Occurrence Handle1:STN:280:DC%2BD3MzjvFGntw%3D%3D Occurrence Handle11251279
B Vos J Hendriks PV Schil RV Hee L Hendrickx (2002) ArticleTitleLong-term results after video-assisted thoracic surgery for spontaneous pneumothorax. Acta Chir Belg 102 439–444 Occurrence Handle12561150
D Waller (1999) ArticleTitleVideo-assisted thoracoscopic surgery for spontaneous pneumothorax: a 7-year learning experience. Ann R Coll Surg Engl 81 1387–392
D Waller J Forty G Moritt (1994) ArticleTitleVideo-assisted thoracoscopic surgery versus thoracotomy for spontaneous pneumothorax. Ann Thorac Surg 58 372–377 Occurrence Handle1:STN:280:ByuA2cnptVw%3D Occurrence Handle8067834
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Gossot, D., Galetta, D., Stern, J. et al. Results of thoracoscopic pleural abrasion for primary spontaneous pneumothorax . Surg Endosc 18, 466–471 (2004). https://doi.org/10.1007/s00464-003-9067-z
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DOI: https://doi.org/10.1007/s00464-003-9067-z