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The Annals of Thoracic Surgery, Vol 53, 1015-1017, Copyright © 1992 by The Society of Thoracic Surgeons
PS Olsen and HO Andersen
From 1979 to 1988 483 patients were admitted with primary spontaneous
pneumothorax. All patients underwent thoracoscopy to identify the cause of
pneumothorax. Chemical pleurodesis with instillation of tetracycline was
performed if cysts less than 2 cm in diameter were found. If larger cysts
were identified the patient underwent thoracotomy. In 93 patients with
cysts larger than 2 cm the recurrence rate after thoracotomy was 4%. In 390
patients treated with intrapleural instillation of tetracycline, the
recurrence rate was 16%. Fifty percent of the recurrences occurred within
30 days. The cause of recurrence in 42 patients (69%) was cysts missed at
the initial thoracoscopy. This study has demonstrated that thoracoscopy is
a reliable and safe method for selection of patients for chemical
pleurodesis. It is, however, necessary that the thoracoscopy is meticulous
to avoid recurrence from missed cysts.
ARTICLES
Long-term results after tetracycline pleurodesis in spontaneous pneumothorax
Department of Cardiothoracic Surgery R, Gentofte Hospital, Hellerup, Denmark.
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