Studying on value of thoracoscopy in the diagnosis and treatment of pneumothorax

ABSTRACT

Background: Thoracoscopy has used for lots of thoracic disorders. Pneumothorax may be ideally suited for thoracoscopic management. Objective: To study the value of thoracoscopy in the diagnosis and treatment of pneumothorax. Subjects and method: From September 2003 to October 2006, 30 patients with pneumothorax were treated by thoracoscopy at Department of Respiratory of Bach Mai Hospital. This was a longitudinal, retrospective and prospective study. Prospective study included 15 patients from September 2005 to October 2006. Retrospective study included 15 patients from September 2003 to August 2005. Results: In 30 patients, primary spontaneous pneumothorax accounted for 80%, secondary spontaneous pneumothorax 13.3%, catamenial pneumothorax 3.3% and iatrogenic pneumothorax 3.3%. Mean age of patients was 34\xb115 years (ranged from 17 to 77 years). 90% of cases were male. Bullea was found in 70% by thoracoscopy. Patients were in stage I 13.3%, stage II 20%, stage III 33.3%, and stage IV 33.3%. There were 3 procedures with ligation, 11 procedures with coagulator, 25 procedures with talc poudrage; mean dose of talc was 8.2\xb12.2 g. The success rates of procedures with talc poudrage were 80% and 100% after supplemental pleurodesis. Complications and side effects were subcutaneous emphysema 46.7%, empyema 3.3%, high fever 3.3% that we thought was nosocomial infections, bleeding in pleural cavity 3.3%, chest pain 96.7%, fever 63.3%, dyspnea 10%. After a mean follow up of 14.1\xb110.4 months, the recurrent rate was 3.3%. Conclusions: Medical thoracoscopy achieved a high success rate in the diagnosis and treatment of pneumothorax.