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Eur J Cardiothorac Surg 2007;31:1106-1109. doi:10.1016/j.ejcts.2007.03.017
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Videothoracoscopic silver nitrate pleurodesis for primary spontaneous pneumothorax: an alternative to pleurectomy and pleural abrasion?

Bertrand Marcheixa, Laurent Broucheta, Claire Renauda, Yoan Lamarcheb, Antoine Mugniota, Vincent Benouaicha, Jean Berjauda, Marcel Dahana,*

a Department of Thoracic Surgery, Rangueil-Larrey University Hospital, Toulouse, France
b Department of Thoracic and Cardiovascular Surgery, Montreal Heart Institute, Montreal, Quebec, Canada

Received 16 December 2006; received in revised form 10 March 2007; accepted 13 March 2007.

* Corresponding author. Address: Department of Thoracic Surgery, Larrey Hospital, 24 chemin de Pouvourville, TSA 30031, 31059 Toulouse Cedex 9, France. Tel.: +33 567 771 803; fax: +33 567 771 483. (Email: dahan.m{at}chu-toulouse.fr).

Background: The optimal surgical management of primary spontaneous pneumothorax (PSP) is still controversial, especially in terms of the technique to be used. The aim of this paper was to report our experience of videothoracoscopic silver nitrate pleurodesis (VATSNP). Methods: Between 1995 and 2004, all the medical records of the patients who had undergone silver nitrate videothoracoscopic pleurodesis (SNVTP) were reviewed. All the patients had systematic prospective clinical and radiological follow-up at 1 month. The last 250 patients were retrospectively recontacted for long-term follow-up. Results: Six hundred and three patients underwent SNVP. No intra-operative death or major complication occurred during or after the procedures. Mean operating time was 40.2 ± 10.7 min. The conversion to thoracotomy rate was 2.5%. Main postoperative complications were prolonged air leak (15.6%), partial residual pneumothorax (5.1%), pleural effusion (2.5%) and postoperative bleeding (2.0%). The follow-up was 100% complete 1 month after discharge; at 1 month, the recurrence rate was 0.5%. The last 250 patients were retrospectively recontacted with a mean follow-up of 2.9 ± 2.3 years (184 patients). The long-term recurrence rate was 1.1%. Conclusions: It is one of the first reports on the use of video-assisted thoracoscopic silver nitrate pleurodesis for PSP. We demonstrate safety and effectiveness of the procedure with long-term results comparable with standard open pleural abrasion or pleurectomy.

Key Words: Pneumothorax • Pleurodesis • Silver nitrate • Video-assisted thoracoscopy






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.