Tratamento Minimamente Invasivo do Pneumotórax: Eficácia da Toracoscopia e Técnicas de Pleurodese

Abstract

Introduction: Pneumothorax is a condition characterized by the presence of air in the pleural cavity, causing pulmonary collapse. It can be spontaneous, traumatic or iatrogenic, and is classified as primary or secondary. Pathophysiology involves the entry of air into the pleural space, interrupting the surface tension that keeps the lung expanded. Treatment varies according to cause and severity, with video-assisted thoracoscopy (VATS) being a preferred option because it allows less invasive interventions. Objective: The objective of this article is to investigate the effectiveness of the minimally invasive treatment of pneumothorax, focusing on video-assisted thoracoscopy (VATS) and pleurodesis techniques. The research compares these methods with traditional approaches, analyzing success rates, recovery, prevention of recurrences and complications, offering a detailed analysis of the advantages and limitations of these techniques in the management of pneumothorax. Methodology: For the study "Minimally Invasive Treatment of Pneumothorax," databases such as PubMed and SCIELO were searched, with DeCS terms. Original articles published between 2015 and 2024 were included. The critical analysis focused on the effectiveness and results of approaches such as thoracoscopy and pleurodesis, ensuring a comprehensive and relevant review. Results and discussion: Video-assisted thoracoscopy (VATS) is an effective and minimally invasive technique for the treatment of pneumothorax, providing lower morbidity and faster recovery compared to traditional thoracotomy. VATS is especially useful in cases of spontaneous primary and secondary pneumothorax, allowing the resection of blebs and pleurodesis to prevent recurrences. Pleurodesis techniques, such as pleural abrasion and partial pleurectomy, are associated with low rates of complications and lower postoperative pain. VATS also makes it possible to treat bilateral pneumothorax in a single procedure. Conclusion: Video-assisted thoracoscopy (VATS) is a minimally invasive and effective technique in the treatment of pneumothorax, offering benefits such as less postoperative pain, reduced hospitalization time and lower rates of complications. Compared to thoracotomy, VATS provides faster recovery and less morbidity, being preferred for primary and secondary spontaneous pneumothorax, in addition to treating bilateral pneumothorax in a single intervention.