THORACOSCOPY FOR SPONTANEOUS PNEUMOTHORAX

Video-assisted thoracic surgical approaches appear to be viable altern atives to thoracotomy when surgical management of spontaneous pneumoth orax is required. Apical bullae of the lung can be resected, and pleur al abrasion can be accomplished with minimal postoperative morbidity a nd usually a shorter postoperative stay in hospital. Fifteen patients with primary (n = 9) and secondary (n = 6) spontaneous pneumothoraces have recently been treated by our group with the video-assisted thorac ic surgical approach. Secondary pneumothoraces in the 6 patients were a result of cystic fibrosis (n = 2) and chronic obstructive pulmonary disease (n = 2), iatrogenic (n = 1), and post heart-lung transplantati on (n = 1). All were treated by endoscopic stapled resection of bullou s disease and pleural abrasion. There were no deaths. In 2 patients wi th secondary spontaneous pneumothorax, recurrent pneumothoraces develo ped eventually requiring thoracotomy for direct surgical management.