SURGICAL-TREATMENT OF SPONTANEOUS PNEUMOTHORAX - 10-YEAR EXPERIENCE

Spontaneous pneumothorax (SP) is commonly observed in young, tall, thi n subjects without apparent underlying lung disease and in the elderly with chronic emphysematous lung disease. We present our experience in treating SP during the last decade. From December 1986 to November 19 96 a total of 417 consecutive patients with SP were admitted to our de partment. There were 349 males (83.7%) and 68 females, ranging in age from 14 to 93 years. A right-side SP was detected in 234 cases (56.1%) , a left-side SP in 175 (42.0%), and a bilateral SP in 8 (1.9%). Treat ment included observation/aspiration (n = 16, 3.8%), tube thoracostomy (n = 372, 89.2%), multiple tubes (n = 29, 7.0%), blood pleurodesis (n = 13, 3.1%), midsternotomy (n = 3, 0.7%), and minithoracotomy (n = 92 , 22.1%). Primary indications for operation were recurrent SP (n = 49) and persistent air leak (n = 46), Blebs or bullae were found in all p atients and mere ablated by stapling, Pleural abrasion was also perfor med. All showed good lung expansion postoperatively, Perioperative mor tality was zero. The mean hospital stay was 6.5 days. Follow-up of 89 patients who had undergone surgical treatment (93.7%) at 1 to 100 mont hs revealed only one recurrence, Tube thoracostomy is still the treatm ent of choice for SP, Surgical intervention is recommended only in cas es of recurrent SP or persistent air leak. Minithoracotomy is a safe s urgical approach with satisfactory cosmetic results.