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Eur J Cardiothorac Surg 2000;18:608-610
© 2000 Elsevier Science NL

How to do it

Bilateral open treatment of spontaneous pneumothorax: a new access

^a Department of Surgery, IRCCS San Matteo, University of Pavia, Pavia, Italy
^b Foundation A. Carrel, Pavia, Italy

Received 16 September 1999; received in revised form 24 July 2000; accepted 22 August 2000.

Corresponding author. Residenza Parco 152, 20080 Basiglio, Milano 3, Italy. Tel.: +39-0382-529118; fax: +39-0382-525853
e-mail: nazaris{at}tin.it

A new technique for bilateral apical bullectomy and pleurectomy via axillary minithoracotomy and transmediastinal access to the contralateral side, was used in 13 patients with bilateral apical blebs and/or pneumothorax. The contralateral space is reached at the posterior superior mediastinum, passing between the first thoracic vertebral bodies (T1–T4) and the oesophagus. The contralateral lung apex is then pulled into the thoracotomy side and apical bullectomy carried out by linear stapler. The obvious advantages of avoiding a second thoracotomy while providing complete solution to the clinical problem are particularly important in young patients with spontaneous pneumothorax caused by bilateral apical blebs.

Key Words: Pneumothorax • Pleurectomy • Blebs • Bullae

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