VIDEOTHORACOSCOPIC TREATMENT OF SPONTANEOUS PNEUMOTHORAX

Thoracoscopic surgery has been well accepted as a treatment for sponta neous pneumothorax and other intrathoracic diseases, Seventy-four pati ents with primary or secondary pneumothorax underwent thoracoscopic op eration in this hospital, There was no postoperative mortality or majo r morbidity, Only two (2.7%) patients developed recurrent pneumothorax postoperatively, but this never reappeared after using bullae resecti on and mechanical pleurodesis in place of electroablation only at an e arlier period. Three patients had residual pleural effusion or air spa ce, and two patients had persistent air-leak postoperatively; all of t hem recovered after conservative treatment, The mean operation time, i ntensive care unit stay, and total hospital stay were decreased signif icantly when compared with open thoracotomy, The low recurrence rate a nd shorter hospital stay also made this procedure much superior to tub e thoracostomy and chemical pleurodesis only, Approaches to make worki ng ports, bullectomy, and pleurodesis are also discussed here, We conc luded that thoracoscopic surgery is highly effective and minimally inv asive for patients with spontaneous pneumothorax, but may not be suita ble for patients with generalized emphysematous change of lungs or den se adhesion of the pleural spaces.