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Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: A single-institution experience in 861 cases

2006; Elsevier BV; Volume: 131; Issue: 2 Linguagem: Inglês

10.1016/j.jtcvs.2005.10.025

1097-685X

Giuseppe Cardillo, Francesco Carleo, Roberto Giunti, Luigi Carbone, Salvatore Mariotta, Lorenzo Salvadori, Lea Petrella, Maria Paola Martelli,

Lung Cancer Diagnosis and Treatment

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