PT  - JOURNAL ARTICLE
AU  - Telma Sequeira
AU  - Luciana Bento
AU  - José Pedro Boléo-Tomé
AU  - Rui Costa
AU  - Fernando Rodrigues
TI  - Medical thoracoscopy management of spontaneous pneumothorax in a pulmonology department: 17 year overview
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P497
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P497.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P497.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Introduction:Management of spontaneous pneumothorax has been debated over decades. Discussion remains over the best time and form of intervention to prevent recurrences.Objectives: Characterization of a pulmonology department experience in managing spontaneous pneumothoraxes through medical thoracoscopy over the last 17 years.Methods:Cohort comprising 76 patients with primary or secondary spontaneous pneumothorax submitted to medical thoracoscopy between 1996-2013. Data were collected from revision of case files. Microsoft Excel®2010 was used for statistical analysis.Results: 88% of patients were male, with an average age of 34 years (minimum 17; maximum 73);78% had a history of smoking. Patients were classified as: primary spontaneous pneumothorax (PSP) 59%; secondary spontaneous pneumothorax (SSP) 38%; iatrogenic 3%. Concerning PSP, 49% of patients were classified as Vanderschueren stage III. Pleurodesis was performed in 40 (89%), with talc poudrage used in 90% of cases and mechanic abrasion on 10%. Electric or thermal (Argon) coagulation was used in 12 (71%) and 5 (29%) cases, respectively. Bullae resection was performed with Endo Gia® in 6 patients. Three patients recurred (7%) within 12 months.SSP revealed equal distribution (31%) in Vanderschueren stage III and IV. Pleurodesis was done in 26 (90%) patients, mostly by talc poudrage (85%). Bullae resection was done in 52% of cases. Success rate was 85%, and 3 patients needed referral to a thoracic surgeon.Conclusion: Optimal management strategy for spontaneous pneumothorax remains undefined. In this series, medical thoracoscopy was shown to be effective, with high success rate, thus avoiding referral to surgery.