[Benign spontaneous pneumothorax: possibilities and prognosis of conservative therapy]

There is much divergence of opinion as to how spontaneous pneumothorax should be treated or even whether it should be treated at all. Nowadays this benign pulmonary disease is primarily treated surgically, although conservative management of spontaneous pneumothorax seems to provide equally good results, as already indicated in 1932 by KJAERGAARD. Histories and clinical findings for 87 patients who were initially treated for spontaneous pneumothorax were reviewed and the factors responsible for the choice of treatment established. The mean age of the patients was 34 years, and 60% of the patients were below 30. Males predominated over females by 8:1. No coexisting pulmonary diseases were found in 80% of the patients. 54 patients were treated conservatively (no treatment except antitussives or analgesics). 46 conservatively treated patients had pneumothorax for the first time; 4 patients each had pneumothorax for the second or third time or more. 46 of 66 patients with idiopathic pneumothorax received no treatment, whereas 12 of 20 patients who had coexisting pulmonary diseases were treated surgically. The pneumothorax did not recur in 30 of 37 patients treated conservatively and observed for 1--15 years. These data suggest that conservative management is as effective as surgical treatment in uncomplicated spontaneous pneumothorax.