Efficacy study of video-assisted thoracoscopic surgery pleurodesis for spontaneous pneumothorax

Background. This study aims to assess the efficacy of video-assisted thorac oscopic surgery pleurodesis in the treatment of spontaneous pneumothorax wi th particular reference to the rate of recurrence after abrasion pleurodesi s and postoperative neuralgia. Methods. One hundred one patients who underwent 109 video-assisted thoracos copic surgery pleurodesis procedures in the Austin & Repatriation Medical C entre between January 1992 and June 1998 were identified from a computerize d database. The follow-up period was from 8 months to 7 years and 1 month ( mean, 44.4 months). Patients were telephoned and asked as to whether recurr ence occurred, and if so, when it occurred and how it was treated. They wer e asked to grade their current pain level from 0 to 6. Results. Eighty-two patients were contacted, corresponding to 88 video-assi sted thoracoscopic surgery pleurodesis procedures that were followed up (80 .7%). There were five recurrences (5.7%). The pain level was rated as 0 in 64 cases (72.7%), 1 in 27 cases (23.9%), 2 in 1 case (1.1%), and 3 in 2 cas es (2.3%). Conclusions. These data suggest that video-assisted thoracoscopic surgery p leurodesis is a valid alternative to thoracotomy with pleurectomy for treat ment of spontaneous pneumothorax with an acceptable recurrence rate and min imal amount of postoperative neuralgia. (C) 2001 by The Society of Thoracic Surgeons.