Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
ANZ J Surg. 2023 Oct;93(10):2402-2405. doi: 10.1111/ans.18552. Epub 2023 Jun 18.
Recurrent primary spontaneous pneumothorax (PSP) is routinely treated by video-assisted thoracoscopic (VATS) talc pleurodesis (with or without localized resection of macroscopic bullous disease). There is a paucity of published data regarding durability of the procedure and the rate of recurrent pneumothorax after such surgery, and this has significant implications from a prognostic and employment limitation perspective.
Patients who underwent a VATS talc pleurodesis (with or without localized resection of macroscopic bullous disease) for the treatment of their second or subsequent PSP or a PSP were followed for recurrent ipsilateral pneumothorax and new contralateral PSP. Follow up was by way of telephone interview and medical record verification out to 48 months.
New contralateral pneumothorax occurred in 7 patients (11.1%) in the talc pleurodesis plus wedge resection group and 2 (1.8%) in the talc pleurodesis only group. There was one case of recurrent ipsilateral pneumothorax in a patient who had no inflammatory response to talc insufflation.
Video-assisted thoracoscopic (VATS) talc pleurodesis (and lung resection for macroscopic bullous disease) is a durable treatment for recurrent PSP. Patients with macroscopic disease have a significant risk of subsequent contralateral PSP.
复发性原发性自发性气胸（PSP）通常通过电视辅助胸腔镜（VATS）滑石胸膜固定术（伴或不伴肉眼疱性疾病的局部切除术）进行治疗。关于该手术的持久性以及手术后气胸复发的比率，发表的数据很少，这从预后和就业限制的角度来看具有重要意义。
对第二次或后续 PSP 或 PSP 行 VATS 滑石胸膜固定术（伴或不伴肉眼疱性疾病的局部切除术）治疗的患者，随访同侧气胸复发和新的对侧 PSP。通过电话访谈和病历核实，随访时间最长为 48 个月。
滑石胸膜固定术加楔形切除术组有 7 例（11.1%）发生新的对侧气胸，滑石胸膜固定术组有 2 例（1.8%）发生新的对侧气胸。在一例对滑石吹入无炎症反应的患者中，出现了同侧气胸复发的情况。
电视辅助胸腔镜（VATS）滑石胸膜固定术（伴或不伴肉眼疱性疾病的肺切除术）是复发性 PSP 的一种持久治疗方法。有肉眼疾病的患者有发生后续对侧 PSP 的显著风险。
