Eficacia y morbimortalidad del tratamiento quirúrgico mediante videotoracoscopia y pleurodesis con talco del neumotórax espontáneo primario / Efficacy, morbidity and morbidity of surgical treatment of a primary spontaneous pneumothorax by videothorascopic talc pleurodesis

Introducción y objetivo Llamamos neumotórax espontáneo primario (NEP) a la presencia de aire en el espacio pleural sin causa o etiología conocida. La característica principal de esta enfermedad es su alta tendencia a la recidiva. Nuestro estudio tiene como objetivos: 1) conocer la eficacia del tratamiento quirúrgico mediante resección pulmonar por videotoracoscopia y pleurodesis con talco, 2) analizar las complicaciones derivadas del uso del talco. Material y métodos Se revisa una serie de 130 casos de NEP tratados mediante videotoracoscopia con o sin resección parenquimatosa y pleurodesis con 3g de talco libre de asbesto (STERITAL®). Hemos recogido datos epidemiológicos, el método diagnóstico, la indicación quirúrgica, la mortalidad, la morbilidad general y la específica de la pleurodesis con talco, el número de recidivas y su tratamiento. Resultados Nuestros pacientes tienen una edad media de 26,4 años, 84,3% son hombres y el 69% tiene hábito tabáquico. La indicación quirúrgica del NEP fue en el 74,4% por recidiva. Registramos una morbilidad del 7% que representan 9 casos, siendo la complicación más frecuente la fuga aérea. No registramos ninguna complicación específica por el uso del talco, tales como empiema, paquipleuritis o síndrome del distrés respiratorio del adulto (SDRA). Se realiza un seguimiento de 10,1 meses de media, constatándose 4 casos de recidiva que representan el 3%.ConclusionesEl tratamiento del NEP mediante videotoracoscopia y pleurodesis con talco tiene una alta eficacia, superior a otras técnicas empleadas para producir pleurodesis, una baja morbilidad general, mortalidad nula, y no registramos ninguna complicación específica debida al talco (AU)

Introduction: A primary spontaneous pneumothorax (PSP) is due to the presence of air in the pleural space and is of unknown cause or a etiology. The main characteristic of this condition is its high tendency to re-occur. This study has two objectives: 1) to determine the efficacy of lung resection surgery using a videothorascope and talc pleurodesis, 2) to analyse the complications originating from the use of talc. Material and methods: A review was carried out on a series of 130 PSP cases treated using videothorascopy, with or without parenchymal resection, and pleurodesis with 3 g of asbestos-free talc (STERITAL1). Epidemiological data were collected, including the diagnostic method, surgical indication, mortality, general morbidity, and the specific morbidity dueto talc pleurodesis, the number of recurrences, and their treatment. Results: The patients had a mean age of 26.4 years, 84.3% were male, and 69% smoked. The surgical indication of the PSP was recurrence in 74.4% of cases. There was morbidity in 7% (9) cases, with the most frequent complication being an air leak. No specific complication, such as empyema, pachypleuritis or adult respiratory distress syndrome (ARDS, on the use of talc was recorded. The mean follow-up was 10.1 months, during which there was recurrence in 4(3%) cases. Conclusions: PSP treatment by videothorascopic talc pleurodesis is highly effective, superior to other techniques use to produce pleurodesis, has a low general morbidity, no mortality, and no specific complications due to the talc (AU)

[Efficacy, morbidity and mortality of surgical treatment of a primary spontaneous pneumothorax by videothorascopic talc pleurodesis]. / Eficacia y morbimortalidad del tratamiento quirúrgico mediante videotoracoscopia y pleurodesis con talco del neumotórax espontáneo primario.

INTRODUCTION: A primary spontaneous pneumothorax (PSP) is due to the presence of air in the pleural space and is of unknown cause or aetiology. The main characteristic of this condition is its high tendency to re-occur. This study has two objectives: 1) to determine the efficacy of lung resection surgery using a videothorascope and talc pleurodesis, 2) to analyse the complications originating from the use of talc. MATERIAL AND METHODS: A review was carried out on a series of 130 PSP cases treated using videothorascopy, with or without parenchymal resection, and pleurodesis with 3g of asbestos-free talc (STERITAL®). Epidemiological data were collected, including the diagnostic method, surgical indication, mortality, general morbidity, and the specific morbidity due to talc pleurodesis, the number of recurrences, and their treatment. RESULTS: The patients had a mean age of 26.4 years, 84.3% were male, and 69% smoked. The surgical indication of the PSP was recurrence in 74.4% of cases. There was morbidity in 7% (9) cases, with the most frequent complication being an air leak. No specific complication, such as empyema, pachypleuritis or adult respiratory distress syndrome (ARDS, on the use of talc was recorded. The mean follow-up was 10.1 months, during which there was recurrence in 4 (3%) cases. CONCLUSIONS: PSP treatment by videothorascopic talc pleurodesis is highly effective, superior to other techniques use to produce pleurodesis, has a low general morbidity, no mortality, and no specific complications due to the talc.