LONG-TERM FOLLOW-UP OF DIFFERENT THERAPY PROCEDURES IN SPONTANEOUS PNEUMOTHORAX

The objective of this follow-up study was to evaluate the success rate of different therapy procedures in spontaneous pneumothorax. In order to achieve comparable conditions the study was restricted to those pa tients who were treated because of a first episode (n = 96) in the tim e between January 1978 and December 1987. Seventy-one were males and 2 5 females, ratio 3:1. The right side to left side ratio was 3:2. Both sides were affected in 11% (n = 11). All patients received an intercos tal tube drainage with a permanent suction. In case of treatment failu re thoracoscopy, pleurodesis or an operation were performed. The follo w-up investigations was performed in January 1990 thus to further eval uate the outcome of 79 patients (82%) after 2 to 12 years after treatm ent. Among the patients, 33 patients presented a persistence or an ear ly recurrence, 26 of them were operated during their first stay in hos pital. A further 25 patients presented a late recurrence, of whom 14 u nderwent a later thoracotomy. Consequently the drainage therapy had a failure rate of 61% (n = 58). The frequency of operation was 42% (n = 40). The results after thoracotomy (n = 26) were as follows: slight co mplications, which did not require surgical treatment occurred in 8% ( n = 2). The long-term results after surgical intervention (lung apex r esection and/or parietal pleurectomy) were excellent concerning the ra te of late recurrences (0% within the follow-up group) and the general condition (96% free or almost free of symptoms) regardless the method of operation. Our data contribute to the fact that the drainage thera py is acceptable only in first episodes of a spontaneous pneumothorax. Every pneumothorax complication however should be treated in speciali zed centers, where thoracoscopies as well as thoracotomies are possibl e.