Video-Assisted Thoracoscopic Introduction of Talc in the Treatment of Recurrent Spontaneous Pneumothorax

OBJECTIVE: To present our experience of using a video-assisted thoracic surgical (VATS) technique to treat spontaneous pneumothorax. DESIGN: Retrospective study. SETTING: Teaching hospital, The Netherlands. SUBJECT: 34 patients with recurrent spontaneous pneumothoraces. INTERVENTION: Combined bullectomy, parietal pleural abrasion, and spraying with talc using the Tissuecol (Immuno) spray device using a VATS technique. Measurement of pain by visual analogue scale (VAS) and analgesic requirements. MAIN OUTCOME MEASURES: Duration of drainage and hospital stay, pain, and morbidity. RESULTS: Patients were followed up after 4 weeks and 1 year. Median drainage time postoperatively was 2 days (range 1-3) and duration of hospital stay 3 days (range 2-5). One pneumothorax recurred and one wound became infected. Patients scored a median of 4 (range 1-9) on the VAS for pain at 4 weeks, and 2 (range 0-6) at 1 year. CONCLUSION: Bullectomy combined with pleural abrasion and the introduction of talc using a VATS technique is safe and effective, and requires only a short hospital stay.