Article Abstract

Thoracoscopic pleural abrasion vs. apical pleurectomy in treatment of spontaneous pneumothorax

Authors: Mariusz Łochowski, Daniel Brzeziński, Łukasz Pryt, Marek Rębowski, Józef Kozak


Background: To compare the efficacy and safety of partial apical pleurectomy and mechanical pleural abrasion in the treatment of spontaneous pneumothorax by performing video thoracoscopy.
Methods: The analysis included 123 patients with spontaneous pleural pneumothorax treated with the thoracoscopic technique in 2006–2015. During the procedure affected lung parenchyma was removed with a stapler and a partial pleurectomy (42 cases) or mechanical abrasion of the pleura (81 cases) were performed. The selection of techniques depended on the surgeon’s preference.
Results: Patients for whom pleurectomy was used had a greater post-operative drainage than patients after pleural abrasion (on average 323.8 vs. 199.3 mL, P=0.068). In no case a conversion or re-operation were necessary. The average time of drainage in both groups was similar (4.3 vs. 4.0 days, P=0.27). Post-operative complications occurred in 8 patients (6%). Three relapses were observed (2.4%): in one of the patients after pleurectomy and two after pleural abrasion (time of observation from 1 to 10 years).
Conclusions: The procedure of pleurectomy is characterised by a greater blood loss than the procedure of pleural abrasion. Both techniques show the same efficacy and low rate of complications in the treatment of spontaneous pneumothorax.