The video-assisted thoracoscopic treatment of spontaneous pneumothorax--our experience with 42 patients

We present our experience with video-assisted thoracoscopic surgical (VATS) treatment of spontaneous pneumothorax (SP) in 42 consecutive patients. We performed 45 video-thoracoscopic procedures during 44 hospitalisations. The most common procedures were: Endo-stapling of bullae in 12 pts, 4 ligations of bullae, 8 suturing of bullae, 27 bleb ablations and catheterizations. In all patients a parietal pleural abrasion was performed. We describe a new variation of mechanical pleurodesis for prevention of recurrences--"linear pleurotomy"--performed in 15 patients. No major complication occurred during surgery. The mean operative time was 67 minutes (range 30 to 160 min). We have 2 conversions to thoracotomy in patients with secondary SP. Two early recurrences were treated one by thoracotomy and the other by re-thoracoscopy. One case of postoperative bleeding required re-thoracoscopy. Four patients had a prolonged air-leak (more than 7 days), but recovered without additional treatment. The mean duration of intercostal drainage was 4.64 days, the mean postoperative hospital stay--6.8 days. We report 95.6% success rate after VATS treatment of SP with mean follow-up period of 21.1 months (2-49 months).