COMPARISON OF VIDEO-ASSISTED THORACOSCOPIC TALCAGE FOR RECURRENT PRIMARY VERSUS PERSISTENT SECONDARY SPONTANEOUS PNEUMOTHORAX

Thoracoscopic talcage (TT) is a safe and effective prophylactic treatm ent fur patients suffering from recurrent primary spontaneous pneumoth orax (PSP), Empirically, TT is considered equally effective in the tre atment of persistent secondary spontaneous pneumothorax (SSP), althoug h this has not yet been proved. In this study, the efficacy and safety of TT was prospectively evaluated in 28 patients (17 males and 11 fem ales, mean age 27+/-8 yrs), with 31 episodes of recurrent PSP, and in 20 patients (13 males and 7 females, mean age 43+/-21 yrs) with persis tent SSP. TT proved to be equally effective in achieving pleurodesis i n both groups: there were 6.5% recurrences in the PSP group and 8.7% i n the SSP group during a mean follow-up period of 18 months (p>0.05). In the SSP group, these were significantly more prolonged postoperativ e air leaks (26 vs 0%; p=0.004) and a longer postoperative chest tube drainage time (35.5+/-18 vs 24.9+/-3.2 hrs; p=0.002) was necessary, Al l air leaks, however, ceased spontaneously during drainage, Duration o f hospitalization was significantly longer in the SSP group (4.7+/-2 v s 3.2+/-0.5 days; p<0.0001). Postoperative pain (90 vs 43%; p<0.0001) and fever (65 vs 17%; p=0.001) were more frequent in the PSP group tha n in the SSP group. There mere no major peri- or postoperative complic ations in either group, We conclude that thoracoscopic talcage is as e fficient and safe in achieving pleurodesis in persistent spontaneous p nuemothorax as in recurrent primary spontaneous pneumothorax.