TREATMENT OF SPONTANEOUS PNEUMOTHORAX BY ENDOSCOPIC FIBRIN GLUE PLEURODESIS

In 33 patients with a recurrent spontaneous pneumothorax, a thoracoscopic pleurodesis with fibrin glue was performed under local anesthesia. During an average postoperative observation peroid of 4 years the relapse frequency was 39 % (13 cases). In these cases thoracotomy was performed and a new relapse of pneumothorax occurred in 3 patients (23 %): Application of thoracoscopy with fibrin glue pleurodesis should only be applied in those patients without large emphysema vesicles and without large coalescences. Under these conditions the relapse frequency could be reduced to 26 %. The thoracoscopic treatment of recurrent pneumothorax by using fibrin glue and local anesthesia in well selected patients is an alternative procedure to thoracotomy.