Videothoracoscopic Talc Poudrage in Primary Spontaneous Pneumothorax: A Single-Institution Experience in 861 Cases

J Thorac Cardiovasc Surg. 2006 Feb;131(2):322-8. doi: 10.1016/j.jtcvs.2005.10.025. Epub 2006 Jan 18.

Abstract

Objective: We sought to evaluate the outcome of 861 patients treated with videothoracoscopic talc poudrage for primary spontaneous pneumothorax.

Methods: From September 1995 through January 2004, a total of 861 patients (578 male, 283 female, mean age 28.6 years) underwent videothoracoscopy for recurrent and complicated primary spontaneous pneumothorax. Patients were treated with videothoracoscopic talc poudrage only (group A: Vanderschueren's stage I, 196 patients; stage II, 112 patients) or videothoracoscopic talc poudrage plus stapling of the blebs/bullae (group B: stage III, 391 patients; stage IV 162 patients). Follow-up included clinical interview and chest radiography (805 patients). In 26 patients (follow-up longer than 5 years), respiratory function was investigated to determine residual volume and diffusing lung capacity.

Results: No operative deaths occurred. No patient had adult respiratory distress syndrome. Postoperative complications occurred in 29 patients (3.36%). The conversion rate to an open procedure was 0.46% (4/861). After a mean follow-up of 52.5 months, 14 patients had recurrences (1.73%). The recurrence rate was 2.41% (7/290) in group A and 1.359% (7/515) in group B (chi2 value: 1.207389; P:.27; odds ratio: 0.56; 95% confidence interval: 0.20-1.62). Results of respiratory function tests were within normal ranges (80% or more of predictive value) in all 26 patients.

Conclusions: Videothoracoscopic talc poudrage achieves a high success rate in the treatment of primary spontaneous pneumothorax with a very low morbidity rate. Recurrences show a statistically significant relationship (P:.037) with smoking habits.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pleurodesis*
  • Pneumothorax / therapy*
  • Recurrence
  • Talc / administration & dosage*
  • Thoracic Surgery, Video-Assisted
  • Thoracoscopy*
  • Video Recording*

Substances

  • Talc