SURGICAL-TREATMENT OF SPONTANEOUS PNEUMOTHORAX BY WEDGE RESECTION WITHOUT PLEURODESIS OR PLEURECTOMY

Objective. Evaluation of wedge resection of the lune without pleurodes is or pleurectomy as a method of surgical treatment for spontaneous pn eumothorax in terms of complications. recurrence rate and postoperativ e complaints. Methods. Retrospective study of 132 operations for spont aneous pneumothorax in 120 patients (84 men and 36 women, mean age 34 years. range 14-77) performed between 1974 and 1993. The mean observat ion time was 84 months (range 6-229) and a 100% follow-up rate of all survivors (97%) was achieved. Results. The indications for surgery wer e recurrent pneumothorax (52%). persisting air leak during first episo de (45%), or hemothorax (3%). Perioperative findings were single bullo us disease (86%), 2-3 bullae (6%), diffuse bullous disease (5%) and no bullous disease in 3% of die cases, The overall complication rate was 16% (30-day mortality 1%, reoperation for postoperative bleeding 2%, bronchopneumonia 8%, new pneumothorax during hospital stay 5%). The la te recurrence rate (operated lung) was 5%. All recurrences were succes sfully treated by drainage (n=3), exsufflation (n=1) or observation on ly (n=3). Reoperation was not necessary. Thirty-seven percent of the p atients had postoperative complaints which they associated with the op eration. Conclusion. Lung resection without pleurodesis or pleurectomy is a sim pie, safe and effective method of the surgical treatment of spontaneous pneumothorax in terms of complications and recurrence rate in patients with limited bullous disease.