Abstract:
OBJECTIVES:To prospectively study all patients with COPD and spontaneous pneumothorax (SP) who underwent thoracoscopic talc poudrage (TP) under local anesthesia to determine its efficacy and safety in recurrence prevention. METHODS:Data on clinical measurements, complications, duration of chest tube drainage, length of hospital stay, and outcome were collected. RESULTS:Forty-one patients (38 men and 3 women) with a mean (+/- SD) age of 70.7 +/- 7.2 years were treated. All patients had COPD, with a mean FEV(1) of 41 +/- 14% predicted. The majority of SPs measured 20 to 50% in size, and 34% were recurrent. Three grams of talc were insufflated into the pleural cavity without complications. Thirteen patients (32%) complained of pain, 5 (12%) developed fever, 27 (66%) had subcutaneous emphysema, and 7 (17%) had prolonged air leaks. Postoperative chest tube drainage and hospital stay were 4 and 5 days, respectively. Success was 95% after a median follow-up of 35 months. Four patients with FEV(1) of < 40% predicted died within 30 days of the procedure, yielding a mortality rate of 10%. FEV(1) (in liters), FEV(1) (in % predicted), and ischemic heart disease were risk factors that influenced early mortality. CONCLUSION:Thoracoscopic TP is effective for pneumothorax prevention and can be performed with acceptable mortality in patients with advanced COPD.
journal_name
Chestjournal_title
Chestauthors
Lee P,Yap WS,Pek WY,Ng AWdoi
10.1378/chest.125.4.1315subject
Has Abstractpub_date
2004-04-01 00:00:00pages
1315-20issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(15)32091-2journal_volume
125pub_type
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