Spontaneous pneumothorax is a potentially life-threatening condition. Prior to 1978, treatment involved either conservative therapy consisting of rest, needle puncture, or thoracic cavity drainage or a thoracotomy. The development and introduction of new methods of treatment can provide effective alternatives for treating spontaneous pneumothorax.
The introduction of the rigid thoracoscope in 1978 opened the way to improvements in the treatment of spontaneous pneumothorax. In 1987, Takeno reported on treatment using a rigid thoracoscope and high-frequency electrocoagulation (SPECT) of 954 cases with 130 recurrences (14 percent); and in 1989, Wakabayashi reported successful results using the technique in nine out of ten cases without any recurrence. In our experience, recurrence occurred in only 3 (18 percent) out of the 17 patients treated with a rigid thoracoscope. On the other hand, regarding limitations in the topical use of SPECT, Takeno cited a bleb size of less than 5 cm in diameter, fewer than five blebs, and a dead angle position of the thoracoscope (for example, the vertical septum side) and stated that 11 percent of all patients with pneumothorax automatically underwent thoracotomy without SPECT based upon radiography of the thoracic cavity.