As video-assisted thoracoscopic surgery has been performed for more than five years
an inquiry was made to register and if possible to evaluate different pleurodesis
procedures in the treatment of pneumothorax in Germany. 19 institutions provided information
about 1365 Operations. Overall there were 88 recurrences (6.5%). 26 (1.9%) severe
bleeding complications or hemothorax and 39 (2.9%) persisting air leaks required further
interventions. There were two (0.1 %) hospital deaths. Recurrence rates showed a significant
(p < 0.001) correlation to the type of pleurodesis used. Talcum pleurodesis had no
recurrences and fibrin glue pleurodesis had the highest rate of recurrence (16.4%)
both procedures being less frequent. After causal treatment, i.e. resection without
any pleurodesis, recurrence rate is inconsistent and was 10.2% overall. Pleural abrasion
was followed by a recurrence rate of 7.9% and pleurectomy of 4.4%. Both procedures
induced significantly (p = 0.01) more bleeding complications (about 3%) than other
procedures (0.4%). Promising was coagulation of the pleura parietalis with a recurrence
rate of only 2.7 % and a low rate of complications.
Pleurodesis - Spontaneous pneumothorax - Thoracoscopic surgery - Survey
