Surgical treatment of the spontaneous pneumothoraces and its pathological findings

Open thoracotomies were performed in 124 out of 198 spontaneous pneumothorax episodes from Jan. 1967 to Dec. 1976. By reviewing histological findings of resected specimens, elastofibrosis was remarkable in particular and bullae seem to arise from this elastofibrosis. This change could be irreversible and causes frequent recurrence. So only conservative treatment is not enough and is needed surgical treatment. Regarding operation we prefer bullectomy and/or partial parietal pleurectomy. The latter is useful to reserve pulmonary function and can gain necessary adhesion of the place where frequent bullae formation are observed. And after performing parietal pleurectomy, there is no recurrence.