Journal Article

Videothoracoscopic silver nitrate pleurodesis for primary spontaneous pneumothorax: an alternative to pleurectomy and pleural abrasion?

Bertrand Marcheix, Laurent Brouchet, Claire Renaud, Yoan Lamarche, Antoine Mugniot, Vincent Benouaich, Jean Berjaud and Marcel Dahan

in European Journal of Cardio-Thoracic Surgery

Published on behalf of European Association for Cardio-Thoracic Surgery

Volume 31, issue 6, pages 1106-1109
Published in print June 2007 | ISSN: 1010-7940
Published online June 2007 | e-ISSN: 1873-734X | DOI: https://dx.doi.org/10.1016/j.ejcts.2007.03.017
Videothoracoscopic silver nitrate pleurodesis for primary spontaneous pneumothorax: an alternative to pleurectomy and pleural abrasion?

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  • Cardiovascular Medicine
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Abstract

Background: The optimal surgical management of primary spontaneous pneumothorax (PSP) is still controversial, especially in terms of the technique to be used. The aim of this paper was to report our experience of videothoracoscopic silver nitrate pleurodesis (VATSNP). Methods: Between 1995 and 2004, all the medical records of the patients who had undergone silver nitrate videothoracoscopic pleurodesis (SNVTP) were reviewed. All the patients had systematic prospective clinical and radiological follow-up at 1 month. The last 250 patients were retrospectively recontacted for long-term follow-up. Results: Six hundred and three patients underwent SNVP. No intra-operative death or major complication occurred during or after the procedures. Mean operating time was 40.2 ± 10.7 min. The conversion to thoracotomy rate was 2.5%. Main postoperative complications were prolonged air leak (15.6%), partial residual pneumothorax (5.1%), pleural effusion (2.5%) and postoperative bleeding (2.0%). The follow-up was 100% complete 1 month after discharge; at 1 month, the recurrence rate was 0.5%. The last 250 patients were retrospectively recontacted with a mean follow-up of 2.9 ± 2.3 years (184 patients). The long-term recurrence rate was 1.1%. Conclusions: It is one of the first reports on the use of video-assisted thoracoscopic silver nitrate pleurodesis for PSP. We demonstrate safety and effectiveness of the procedure with long-term results comparable with standard open pleural abrasion or pleurectomy.

Keywords: Pneumothorax; Pleurodesis; Silver nitrate; Video-assisted thoracoscopy

Journal Article.  2707 words. 

Subjects: Cardiovascular Medicine ; Cardiothoracic Surgery

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