Therapeutic Effect Of Medical Thoracoscopy On Refractory Pneumothorax

Objective: To explore the efficacy and safety of medical thoracoscopy in the treatment of refractory pneumothorax.Methods: Data of totally 14 patients of refractory pneumothorax with subpleural blebs treated in the Second Affiliated Hospital of Guangxi Medical University from 2012 to 2018 were retrospectively analyzed,Combined treatment by high-frequency electric coagulation、argon plasma coagulation(APC)under medical thoracoscopic practice.Results: Among the 14 patients with refractory pneumothorax,there were 2patients with type II pulmonary bullae according to the classification of pulmonary bullae under endoscope.There were 2 patients with type III pulmonary bullae and 3 patients with V-type pulmonary bullae.A total of 42 pulmonary bullaes were found in 14 patients.The cause of pneumothorax was confirmed by thoracoscopy.Interventional treatments such as release of adhesion,clamp and cauterization of pulmonary bullae were performed in treatment.The average indwelling time of drainage tube was 8.71 ±5.77 days,and the lungs of 14 patients were completely reopened within 24 hours after treatment.11 cases stopped air leakage within 3 days after operation and 3 cases stopped air leakage within 2weeks.At their discharge,all patients had no air leakage on chest X-ray,and the short-term effective rate was 100%.There was no pneumothorax recurrence after1 year follow-up,and the long-term effective rate was 100%.Conclusion: The use of medical thoracoscopy in the treatment of refractory pneumothorax has the advantages of less trauma,less pain and faster recovery after operation,which is worthy of clinical practice in China.