To review our experience of treatment of primary spontaneous pneumothorax by videothoracoscopic talc pleurodesis.
From 2000 to 2008, 124 consecutive patients with primary spontaneous pneumothorax were operated; 105 were men (84.7%) and 19 were women (15.3%) with a mean age of 26.6 years (range 17–46 years).
No mortality was recorded. Staging according to Vanderschueren’s classification was as follows: stage I, 61 patients (45.9%); stage II, 39 patients (29.3%); stage III, 31 patients (23.3%); stage IV, two patients (1.5%). The overall rate of complications was 9% (12/133), corresponding to prolonged air leak in 9(6.7%) patients and hemothorax in 3(2.2%) patients. Four patients (3%) had recurrence requiring reoperation. There were no episodes of acute respiratory failure, pneumonia or subcutaneous emphysema following talc pleurodesis.
Thoracoscopic pleural talc pleurodesis as a treatment for recurrent pneumothorax is easy, safe, and rapid, and causes minimal morbidity and mortality.
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Sahn SA, Heffner JE (2000) Spontaneous pneumothorax. N Engl J Med 342:868–874
Doddodi C, Barlési f, Fraticelli A, Thomas P, Astoul P, Giudicelli R et al (2004) Video-assisted thoracoscopic management of recurrent primary spontaneous pneumothorax after prior talc pleurodesis: a feasible, safe and efficient treatment option. Eur J Cardiothorac Surg 26:889–892
Noppen M, Baumann MH (2003) Pathogenesis and treatment of primary spontaneous pneumothorax: an overview. Respiration 70:431–438
Noppen M, Schramel F (2002) Pneumothorax. Eur Respir Rev 7:279–296
Tschopp JM, Rami-Porta R, Noppen M, Astoul P (2006) Management of spontaneous pneumothorax: state of the art. Eur Respir J 28:637–650
Tumbarello M, Tacconelli E, Pirronti T, Cauda R, Ortona L (1997) Pneumothorax in HIV-infected patients: role of Pneumocystis carinii pneumonia and pulmonary tuberculosis. Eur Respir J 10:1332–1335
Baumann MH, Strange C, Heffner JE, Light R, Kirby T, Klein J, Luketich J, Panacek EA, Sahn SA, AACP Pneumothorax Consensus Group (2001) Management of spontaneous pneumothorax: an American of chest physicians Delphi consensus statement. Chest 119:590–602
Gossot D, Galetta D, Stern JB, Debrosse D, Caliandro R, Girard P et al (2004) Results of thoracoscopic pleural abrasion for primary spontaneous pneumothorax. Surg Endosc 18:466–471
Henry M, Arnold T, Harvey J (2003) BTS guidelines for the management of spontaneous pneumothorax. Thorax 58(supp 2):39–52
Lang-Lazdunski L, Chapuis O, Bonnet PM, Pons F, Jancovici R (2003) Videothoracoscopic bleb excesion and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term results. Ann Thorac Surg 75:960–965
Bresticker MA, Oba J, LoCicero J 3rd, Greene R (1993) Optimal pleurodesis: a comparative study. Ann Thorac Surg 55:364–366
Carvalho P, Knight LL, Olson R, Crowley JJ, Hawk PA, Charan NB (1995) Effects of erythromycin on the rabbit pleura: its potential role as a pleural sclerosant. Am J Respir Crit Care Med 151:1228–1232
Miller Q, Meschter C, Neumaster T, Pratt J, Moulton M, Downey D et al (2007) Comparison of pleurodesis by erythromycin, talc, doxycycline, and diazepam in a rabbit model. J Surg Educ 64:41–45
Vargas FS, Teixeira LR, Silva LM, Carmo AO, Light RW (1995) Comparison of silver nitrate and tetracycline as pleural sclerosing agents in rabbits. Chest 108:1080–1083
Györik S, Erni S, Studler U, Hodek-Wuerz R, Tamm M, Chhajed PN (2007) Long-term follow-up of thoracoscopic talc pleurodesis for primary spontaneous pneumothorax. Eur Respir J 29:757–760
Gillet-Juvin K, Guérin JC (1991) Le talcage sous thoracoscopie des pneumothorax par rupture de bulles d’emphysème. Rev Mal Resp 8:289–293
Vandershueren RG (1981) Le talcage pleural dans le pneumothorax spontané. Poumon Coeur 31:273–276
Lange P, Mortensen J, Groth S (1988) Lung function 22–35 years after treatment of idiopathic spontaneous pneumothorax with talc poudrage or simple drainage. Thorax 43:559–561
Research Committee of the British Thoracic Association and the Medical Research Council Pneumoconiosis Unit (1979) A survey of the long-term effects of talc and kaolin pleurodesis. Br J Dis Chest 73(3):285–288
Fraticelli A, Robaglia-Schlupp A, Riera H, Monjanel-Mouterde S, Cau P, Astoul P (2002) Distribution of calibrated talc after intrapleural administration: an experimental study in rats. Chest 122(5):1737–1741
Cardillo G, Carleo F, Giunti R, Carbone L, Mariotta S, Salvadori L et al (2006) Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: a single-institution experience in 861 cases. J Thorac Cardiovasc Surg 131:322–328
Hunt I, Barber B, Southon R, Treasure T (2007) Is talc pleurodesis safe for young following primary spontaneous pneumothorax? Interact Cardiovasc Thorac Surg 6(1):117–120
Drs. Ramos, Moya, Macia, Rivas, Ureña, Rosado, Escobar, Saumench, Cabrera, Delgado, Villalonga, and Ramos-Izquierdo have no conflicts of interest or financial ties to disclose.
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Ramos-Izquierdo, R., Moya, J., Macia, I. et al. Treatment of primary spontaneous pneumothorax by videothoracoscopic talc pleurodesis under local anesthesia: a review of 133 procedures. Surg Endosc 24, 984–987 (2010). https://doi.org/10.1007/s00464-009-0707-9
- Spontaneous pneumothorax
- Thoracoscopic surgery
- Talc pleurodesis
- Local anesthesia