Thoracoscopic treatment of pneumothorax

We reviewed a total of 30 procedures performed in 23 consecutive patients since January 1995, 18 male and 5 female (mean age 35.57, range 12-74). Among these 6 had emphysema, 2 giant bullae, 1 sarcoidosis and 1 histiocytosis. Ten patients were at the first episode. In 10 cases pneumothorax was on the right, 9 on the left and 3 bilateral. In 3 patients with evidence of controlateral lesions the procedure was bilateral. Mean operative time was 49 min (range 25-120). Bullae or blebs were resected in 17 patients, Pleural abrasion was associated in 18 patients and subtotal pleurectomy in 5. No mortality nor major morbidity was recorded. Mean drainage time was 4.3 days (range 1-13) and mean hospital stay 6.57 days (range 2-25). We had no ipsilateral recurrence. To conclude, video-thoracoscopic approach can be now considered the gold standard in the treatment of the pneumothorax even at the first episode or in debilitated patients.