Surgical treatment of spontaneous pneumothorax by wedge resection without pleurodesis or pleurectomy

• Published in: European journal of cardio-thoracic surgery Vol. 10; no. 8; pp. 656 - 659
• Main Authors: KÖRNER, H, ANDERSEN, K. S, STANGELAND, L, ELLINGSEN, I, ENGEDAL, H
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 1996; Elsevier Science
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Chi-Square Distribution; Female; Humans; Lung - surgery; Male; Medical sciences; Middle Aged; Pleurodesis; Pneumology; Pneumothorax - diagnosis; Pneumothorax - etiology; Pneumothorax - surgery; Postoperative Complications - physiopathology; Probability; Recurrence; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Surgical Procedures, Operative - methods; Treatment Outcome; Human; Pneumothorax; Treatment; Effusion; Wedge resection; Respiratory disease; Surgery; Pleural disease; Technique; Pneumectomy
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(96)80381-2

OBJECTIVE: Evaluation of wedge resection of the lung without pleurodesisor pleurectomy as a method of surgical treatment for spontaneouspneumothorax in terms of complications, recurrence rate and postoperativecomplaints. METHODS: Retrospective study of 132 operations for spontaneouspneumothorax in 120 patients (84 men and 36 women: mean age 34 years, range14-77) performed between 1974 and 1993. The mean observation time was 84months (range 6-229) and a 100% follow- up rate of all survivors (97%) wasachieved. RESULTS: The indications for surgery were recurrent pneumothorax(52%), persisting air leak during first episode (45%), or hemothorax (3%).Perioperative findings were single bullous disease (86%), 2-3 bullae (6%),diffuse bullous disease (5%) and no bullous disease in 3% of the cases. Theoverall complication rate was 16% (30-day mortality 1%, reoperation forpostoperative bleeding 2%, bronchopneumonia 8%, new pneumothorax duringhospital stay 5%). The late recurrence rate (operated lung) was 5%. Allrecurrences were successfully treated by drainage (n = 3), exsufflation (n= 1) or observation only (n = 3). Reoperation was not necessary.Thirty-seven percent of the patients had postoperative complaints whichthey associated with the operation. CONCLUSION: Lung resection withoutpleurodesis or pleurectomy is a simple, safe and effective method of thesurgical treatment of spontaneous pneumothorax in terms of complicationsand recurrence rate in patients with limited bullous disease.