VIDEO-ASSISTED THORACOSCOPIC SURGERY FOR SPONTANEOUS PNEUMOTHORAX - RESULTS AFTER 4 YEARS

A total of 41 cases (11 female, 30 male) for non-malignant spontaneous pneumothorax received thoracoscopic surgery between March 1991 and Ap ril 1994. All patients entered a prospective trial. Five conversions t o an open procedure were necessary. Of the remaining 36 cases, 30 rece ived thoracoscopic bulla resection and 35 pleurodesis. No patients wer e lost during the median follow-up period of 24.2 months (minimum 9.7 months). Two partial relapses (5.6%) were noticed, A striking high inc idence of sensory loss of the chest wall or pain was observed after co agulation of the parietal pleura or pleurectomy (15 out of 33, 45.5%). Severe pain was experienced by only one patient after coagulation (5. 5%) compared to four after pleurectomy (26.6%). AII three patients wit hout these procedures were free of these complications. An increased r ecurrence rate may be assumed for cases without any visible changes or with disseminated bullae. After an entire resection of circumscribed bullous changes, additional pleurodesis, with its specific complicatio ns, may be an overtreatment Complications that exceed those of tube dr ainage treatment limit a more liberal indication for video-thoracoscop ic treatment of spontaneous pneumothorax.