A. N. V. Koteswara Rao, Pranitha Peddakurma, Ramya Reddy Malipeddi, Pradyut Waghray, Venkateswara Reddy Tummuru

Abstract

Introduction: Jacobaeus Hans-Christian, a Swedish internist, Professor of Medicine, explored thoracic cavity in 1910. He developed thoracoscopy in the early 1900s as a method to break down adhesions to create pneumothorax in patients with pulmonary tuberculosis. Thoracoscopy was used extensively for this purpose until 1945 when streptomycin was introduced in the treatment of tuberculosis. However, in this era with advances in science and technology, thoracoscopy is mainly used in the etiological diagnosis of pleural effusions and therapeutic procedures such as pleurodesis in cases of pneumothorax and adhesiolysis in cases of loculated pleural effusions and empyemas. This study was taken up to report our experience with medical thoracoscopy in cases of “Chronic Pneumothoraces.”

Methodology: It is a prospective study taken up by the Department of Pulmonary Medicine of SVS Medical College and Hospital, Mahabubnagar, Telangana. All the enrolled cases of chronic pneumothorax which satisfy the inclusive criteria were taken into the study from January 2018 to June 2018.

Results: Of 10 patients, eight were male and two were female. Among males, four were smokers. Negative suction was tried in all of them but only two improved after it. Then, thoracoscopy was performed in eight patients, of which seven showed complete expansion of lung and one did not show complete lung expansion, which was referred to computed tomography surgeon. Thoracoscopic findings revealed that all eight had septations, two had large bullae, and two had thick visceral pleura.

Conclusion: In our study, we observed a definitive therapeutic role of medical thoracoscopy in chronic pneumothoraces also. Hence, pulmonologists should consider observing the pleural cavity with rigid thoracoscope first in chronic pneumothoraces before referring the case for any further invasive procedure.

Key words: Chronic pneumothorax, thoracoscopy, pleural effusions, empyemas

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