SURGICAL-TREATMENT IN THE MANAGEMENT OF RECURRENTTRACT SPONTANEOUS PNEUMOTHORAX BASED ON A SERIES OF 278 CASES

Over the past 19 years, 278 patients (238 men - 40 women) have undergo ne 325 parietal pleurectomies: 311 transaxillary apical and 14 full pl eurectomies. Mean age was 32 +/- 12 years. The overall male : female r atio was 6:1. Surgical treatment was performed for either recurrence o f spontaneous pneumothorax or failure to respond adequately to managem ent by tube drainage. Thirty-six patients underwent one stage bilatera l apical pleurectomy. On the basis of our experience (idiopathic pneum othorax: 311 ; chronic obstructive lung disease: 12; histiocytosis X:2 ), we advocate the use of transaxillary apical pleurectomy for the you nger age group with recurrent idiopathic pneumothorax and a full pleur ectomy in the older age group. Major complications occurred in 1.9% of cases (re-exploration for haemorrhage : 5 cases; for air leak: 1 case ). The recurrence rate in this group of patients was 1% (3 in 278 pati ents : one of them has been reoperated).