VIDEOTHORACOSCOPIC TREATMENT FOR SPONTANE OUS PNEUMOTHORAX - TECHNIQUE AND PRELIMINARY-RESULTS

The acceptance of operative therapy of spontaneous pneumothorax (SPT) has been tempered by the serious trauma of thoracotomy access. Develop ment of videoequipment and miniaturized instruments allows now a thora coscopic resection of bulla with minimal access. 25 patients with recu rrent SPT (n = 15), primary resistant SPT (n = 5), and first SPT (n = 5) were treated from January 1991 thoracoscopically. Bullae resection was performed with an Roeder ligature or an Endo-GIA. Pleurodeses was induced by mechanical irritation or coagulation of the upper thoracic aperture with the argon beamer. Postoperative lung reinflation was rap id and without patchy collapse. The analgetic drug demand was dramatic ally reduced and patients were mobilised on the lst postoperative day. Patients were discharged on the 4th postoperative day. Major complica tion were one hematothorax and one recurrence of SPT. The advantages o f the thoracoscopic surgical treatment are rapid full expansion of the lung, decreased postoperative pain, short postoperative hospital stay and early return to normal activity.