[Treatment of spontaneous pneumothorax]

Following an analysis of current treatment strategies for spontaneous pneumothorax and their surrounding controversies, the paper reports the Authors' personal experience. From 1 January 1984 to 31 December 1989 a total of 76 cases of spontaneous pneumothorax were treated, of which 3 were bilateral. The M:F ratio was 9:1 and the age of patients ranged between 16 and 77 years (mean age 39.2); 22 cases were relapses (27.8%). Conservative therapy was used in 12 cases (15.1%); pleural drainage was introduced in 54 cases (68.3%) for a mean of 7.5 days. Fourteen thoracotomies were performed in 13 patients (10.4%): bullectomy was performed 10 times with stapler, whereas pleurodesis was obtained in 9 cases using pleural abrasion and in 5 cases using apical pleurectomy plus pleural abrasion. Axillary thoracotomy at the 5th space was most commonly used. No major complications were observed during the postoperative period and, in spite of the minimum follow-up of 3 months, no cases of relapse were observed in operated patients.