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Long-term follow-up of thoracoscopic talc pleurodesis for primary spontaneous pneumothorax

Depts of ¹ Pulmonary Medicine, and, ² Radiology, University Hospital Basel, Basel, Switzerland. ³ The authors contributed equally to the present article.

CORRESPONDENCE: P. N. Chhajed, Pulmonary Medicine, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland. Fax: 41 612654587. E-mail: pchhajed{at}uhbs.ch

Keywords: Pneumothorax, talc, thoracoscopy

Received: September 18, 2006
Accepted December 4, 2006

The aim of the present study was to evaluate the long-term outcome of patients with primary spontaneous pneumothorax treated with talc pleurodesis.

A follow-up study was undertaken in all patients with primary spontaneous pneumothorax who underwent talc pleurodesis for prolonged air leak or recurrence using thoracoscopy.

In total, 112 patients underwent pleurodesis and follow-up data was obtained in 63 (56%) patients: 45 patients were available for clinical follow-up, 14 for telephone follow-up and four were dead. The causes of death were unrelated to the pleurodesis. There were no episodes of acute respiratory failure following pleurodesis. A total of 56 (95%) out of the cohort of 59 patients had a successful pleurodesis. Surgical pleurectomy was required in three (5%) patients for persistent air leak. Median duration of follow-up after talc pleurodesis was 118 months. Long-term success was observed in 53 (95%) out of 56 patients. Recurrent pneumothorax was observed in three (5%) out of 56 patients. Patients with successful talc pleurodesis had a median forced vital capacity (FVC) of 102% and median total lung capacity of 99% at follow-up. Comparing smokers and nonsmokers, the forced expiratory volume in one second (FEV₁) was significantly lower in smokers and there was a tendency for the FEV₁/FVC ratio to be lower in smokers.

Talc pleurodesis in patients with primary spontaneous pneumothorax via thoracoscopy is an effective procedure associated with normal lung function in patients who do not smoke.

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