European Journal of Cardio-Thoracic Surgery, Vol 10, 656-659, Copyright © 1996 by European Association for Cardio-thoracic Surgery
Surgical treatment of spontaneous pneumothorax by wedge resection without pleurodesis or pleurectomy
H Korner, KS Andersen, L Stangeland, I Ellingsen and H Engedal
Department of Heart Disease, Haukeland Hospital, University of Bergen, Norway.
OBJECTIVE: Evaluation of wedge resection of the lung without pleurodesis or
pleurectomy as a method of surgical treatment for spontaneous pneumothorax
in terms of complications, recurrence rate and postoperative complaints.
METHODS: Retrospective study of 132 operations for spontaneous pneumothorax
in 120 patients (84 men and 36 women: mean age 34 years, range 14-77)
performed between 1974 and 1993. The mean observation time was 84 months
(range 6-229) and a 100% follow- up rate of all survivors (97%) was
achieved. 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. The
overall complication rate was 16% (30-day mortality 1%, reoperation for
postoperative bleeding 2%, bronchopneumonia 8%, new pneumothorax during
hospital stay 5%). The late recurrence rate (operated lung) was 5%. All
recurrences 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 which
they associated with the operation. CONCLUSION: Lung resection without
pleurodesis or pleurectomy is a simple, safe and effective method of the
surgical treatment of spontaneous pneumothorax in terms of complications
and recurrence rate in patients with limited bullous disease.
