COMMON METHODS OF PLEURODESIS - EVALUATION OF THE RESULTS IN THE TREATMENT OF PNEUMOTHORAX

This survey addressed common methods of video-assisted thoracoscopic p leurodesis for spontaneous pneumothorax. A questionnaire asking for fr equency, recurrence rate and complications of the different methods of pleurodesis was sent to all hospitals that belong to the German Socie ty for Thoracic surgery. 19 hospitals reported on a total of 1365 oper ations. 88 recurrences (6.5%), 26 severe bleeding complications (1.9%) , 39 persisting air leaks (2.9%) and two hospital deaths (0.1%) had be en observed. Pleurectomy and pleural abrasion were the most common pro cedures but induced significant (p = 0.01) more bleeding complications (3.1% and 2.6%) than all other methods of pleurodesis (0.4%). Overall recurrence rates depended significantly on the chosen procedure (p = 0.0013). Pleurectomy (4.4%) and coagulation of the pleura (2.7%) showe d better results than the average. Due to smaller numbers of operation s and the widely differing results this significance cannot be shown f or the individual recurrence rates of the different clinics. This surv ey demonstrated a trend towards lower rates of recurrence and complica tions after coagulation of the pleura parietalis. The retrospective ch aracter of the investigation and extremely different recurrence rates for different hospitals demand cautious interpretation of these result s.