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Spontaneous pneumothorax.

S Mattila, S Kostiainen

    Scandinavian Journal of Thoracic and Cardiovascular Surgery
    |January 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Spontaneous pneumothorax, often affecting young men due to ruptured blebs, saw a 25% recurrence rate. Surgery after failed conservative treatment prevented recurrence, suggesting tube drainage followed by thoracotomy if needed offers the best results.

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    Area of Science:

    • Thoracic Surgery
    • Pulmonology
    • Clinical Medicine

    Background:

    • Spontaneous pneumothorax is a significant clinical condition, predominantly affecting young males.
    • Ruptured subpleural blebs are the primary cause in the majority of spontaneous pneumothorax cases.
    • Increased incidence observed in older patients with comorbidities like tuberculosis and chronic bronchitis.

    Purpose of the Study:

    • To present a ten-year clinical series of spontaneous pneumothorax patients.
    • To evaluate the efficacy of conservative versus surgical primary treatment for spontaneous pneumothorax.
    • To analyze recurrence rates and long-term outcomes following different treatment modalities.

    Main Methods:

    • Retrospective analysis of 219 patients with spontaneous pneumothorax over a ten-year period.

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  • Average follow-up duration of 9 years.
  • Comparison of outcomes between primary conservative management (intercostal tube drainage) and surgical intervention (plication or bleb resection/suture).

    • Main Results:

    • 25% recurrence rate (55 out of 219 patients) observed overall.
    • Primary conservative treatment failed in 41 cases, necessitating surgical intervention.
    • No recurrences were reported in patients who underwent operative treatment.
    • Five re-operations were required, primarily for prolonged air leak or bleeding.
    • A 1% mortality rate was associated with spontaneous pneumothorax.

    Conclusions:

    • Intercostal tube drainage is recommended as the initial treatment for spontaneous pneumothorax.
    • Thoracotomy is an effective surgical option for cases where conservative treatment fails, providing good permanent results.
    • Surgical intervention, including plication or bleb resection and suture, appears to eliminate recurrence risk.