Spontaneous pneumothorax rates following video‐assisted thoracoscopic talc pleurodesis with or without resection of macroscopic bullous disease.

Background: 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. Methods: 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. Results: 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. Conclusion: 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. Recurrence rates for spontaneous pneumothorax rates post intervention with VATS talc pleurodesis ± resection of bullous disease. VATS talc pleurodesis (and lung resection for macroscopic bullous disease) is a durable treatment for recurrent primary spontaneous pneumothorax (PSP). Patients with macroscopic disease have a significant risk of subsequent contralateral PSP. [ABSTRACT FROM AUTHOR]