Results of Silver Nitrate Pleurodesis in Spontaneous Pneumothorax

¹ Department of Chest Surgery, Centofte Hospital, Copenhagen, Denmark

Pleurodesis induced by silver nitrate is a simple and safe procedure when performed on the correct indications in the treatment of spontaneous pneumothorax, i.e., for patients with only small or no blebs visible on thoracoscopy or with no or only mild pre-existing lung disease. It entails few complications and little risk. Long-term results are excellent. The procedure prevents recurrences seen in similar cases treated conservatively. Our recurrence rate in 132 cases was 1.5 per cent (two cases). Both were treated effectively with repeated pleurodesis. For patients with serious preexisting lung diseases, simple drainage should be tried before pleurodesis. Thoracotomy with resection is indicated only in the event of major cysts. Decortication is the method of choice in chronic pneumothorax. Among 128 cases in whom pleurodesis was performed, two required supplementary decortication because of incomplete expansion of the lung.