VATS or simple talc poudrage under medical thoracoscopy for recurrent spontaneous pneumothorax.

We read with interest the paper by RENA et al. [1] published recently in the European Respiratory Journal. The authors compared two surgical techniques of pleurodesis (i.e., mechanical abrasion and apical pleurectomy). They deliberately selected patients with stage III primary spontaneous pneumothorax (PSP), according to Vanderschueren classification, and showed that mechanical pleural abrasion requiring less time to be performed was safer than apical pleurectomy. It was a well-designed randomised controlled study answering an editorial [2] encouraging more scientific evaluation of videoassisted thoracic surgery (VATS).