Video-Assisted Thoracoscopic Introduction of Talc in the Treatment of Recurrent Spontaneous Pneumothorax

Abstract

To present our experience of using a video-assisted thoracic surgical (VATS) technique to treat spontaneous pneumothorax. Retrospective study. Teaching hospital, The Netherlands. 34 patients with recurrent spontaneous pneumothoraces. Combined bullectomy, parietal pleural abrasion, and spraying with talc using the Tissuecol (Immuno) spray device using a VATS technique. Measurement of pain by visual analogue scale (VAS) and analgesic requirements. Duration of drainage and hospital stay, pain, and morbidity. Patients were followed up after 4 weeks and 1 year. Median drainage time postoperatively was 2 days (range 1-3) and duration of hospital stay 3 days (range 2-5). One pneumothorax recurred and one wound became infected. Patients scored a median of 4 (range 1-9) on the VAS for pain at 4 weeks, and 2 (range 0-6) at 1 year. Bullectomy combined with pleural abrasion and the introduction of talc using a VATS technique is safe and effective, and requires only a short hospital stay.