Abstract
Generally, an operation for pneumothorax is performed under general anesthesia, however, we often have to consider the risks of general anesthesia for high-risk patients. We have operated on cases of intractable pneumothorax under local anesthesia in such high-risk patients. The experience consisted of 12 cases of intractable pneumothorax treated by thoracoscopic surgery under local anesthesia between April, 1996 and March, 2005. The patients consisted of 11 males and one female, with a mean age of 71 years old. All cases but one had a high risk for surgery under general anesthesia, and one patient refused an operation under general anesthesia. The mean total operation time was 50 minutes. There were no intraoperative complications, but there was one death resulting from postoperative pneumonia and empyema. Nine cases achieved surgical success, and their bullae were identified intraoperatively. If surgical indication is examined carefully and preoperative evaluation is performed sufficiently, thoracoscopic operation under local anesthesia is effective, and is thought to be one of the valuable surgical procedures.
