[Surgical treatment of pneumothorax in AIDS patients]

A retrospective review of the charts of 26 patients with the acquired immunodeficiency syndrome (AIDS) treated at the Hotel-Dieu de Montréal was performed. Patients presented a total of 37 pneumothoraces. Eleven cases were recurrent. Bilateral pneumothoraces were documented in three patients, most of them (17) were severe (> 75%). Pneumocystis carinii pneumonia was the most frequently associated pathology. The initial treatment consisted in chest tube drainage. A definitive treatment was indicated in 7 patients with prolonged air leaks (> 10 days) or without lung expansion. Two median sternotomies with bilateral pleurectomies, bullae plication, and talcage were done, and 5 unilateral thoracotomies with pleurectomies and bullae plications were completed. The post-operative survival was variable and related to diseases associated with the syndrome. AIDS related pneumothoraces is a morbid condition which should be treated on an individual basis.