VIDEO-ASSISTED THORACOSCOPIC PLEURODESIS - A SURVEY CONDUCTED BY THE GERMAN-SOCIETY-FOR-THORACIC-SURGERY

As video-assisted thoracoscopic surgery has been performed for more th an five years an inquiry was made to register and if possible to evalu ate different pleurodesis procedures in the treatment of pneumothorax in Germany, 19 institutions provided information about 1365 operations . Overall there were 88 recurrences (6.5%). 26 (1.9%) severe bleeding complications or hemothorax and 39 (2.9%) persisting air leaks require d further interventions. There were two (0.1%) hospital deaths. Recurr ence rates showed a significant (p < 0.001) correlation to the type of pleurodesis used. Talcum pleurodesis had no recurrences and fibrin gl ue pleurodesis had the highest rate of recurrence (16.4%) both procedu res being less frequent. After causal treatment, i.e. resection withou t any pleurodesis, recurrence rate is inconsistent and was 10.2% overa ll. Pleural abrasion was followed by a recurrence rate of 7.9% and ple urectomy of 4.4%, Both procedures induced significantly (p = 0.01) mor e bleeding complications (about 3%) than other procedures (0.4%). Prom ising was coagulation of the pleura parietalis with a recurrence rate of only 2.7% and a low rate of complications.