Thoracoscopic Treatment with Fibrin Sealant of Ruptured Emphysema and Recurring Spontaneous Pneumothorax

Abstract

Thirty-six patients with recurring spontaneous pneumothorax or with pneumothorax resistant to therapy were subjected to thoracoscopy under insufflation anesthesia. In 89% of the cases changes in the lung surface could be identified as the cause for the recurrence. In 29 patients the changes were removed by thoracoscopy and the airleak sealed with 2 ml fibrin sealant, which was successful in 24 cases (84%). In three cases a parenchymal defect had to be additionally sutured and in four other cases an immediate anterolateral thoracotomy had to be performed subsequently, as the condition did not seem reparable by thoracoscopy. In 75% of all cases thoracotomy with all its disadvantages was avoided by this procedure.