Bilateral open treatment of spontaneous pneumothorax: a new access

A new technique for bilateral apical bullectomy and pleurectomy via axillar y minithoracotomy and transmediastinal access to the contralateral side, wa s used in 13 patients with bilateral apical blebs and/or pneumothorax. The contralateral space is reached at the posterior superior mediastinum. passi ng between the first thoracic vertebral bodies (T1-T4) and the oesophagus. The contralateral lung apex is then pulled into the thoracotomy side and ap ical bullectomy carried out by linear stapler. The obvious advantages of av oiding a second thoracotomy while providing complete solution to the clinic al problem are particularly important in young patients with spontaneous pn eumothorax; caused by bilateral apical blebs. (C) 2000 Elsevier Science B.V . All rights reserved.