Simultaneous and non simultaneous bilateral spontaneous pneumothorax patients(273) were reviewed retrospectively from April 1986 to March 1990 in the Dept. of Thoracic and Cardiovascular Surgery, Kyung Hee University Medical College. The incidence of bilateral spontaneous pneumothorax was 13.6%(37) and sexual distribution was male dominant (Male:33, Female:4). The patients were classified into three major groups according to therapeutic methods:Group I (7) :who were treated with simultaneous bilateral operation for unilateral recurred spontaneous pneumothorax through median sternotomy. Mean age was 20.7 years(1728) and follow up duration was 7.7 months (3 weeks2 years). Group U(23);who were treated with staged lateral thoractomy, unilateral thoracotomy and non simultaneous contralateral closed thoracostomy, or simultaneous or non simultaneous bilateral closed thoracostomy. Mean age was 28.6 years (1756) and follow up du -ition was 9.8 months(one week3.5 years). Group M(10) ;who were treated with simultaneous bilateral operation for simultaneous or non simultaneous bilateral spontaneous pneumothorax through median sternotomy. Mean age was 21.4 years(1728) and follow up duration was 12.8 months (2 weeks-2.7 years). Among the patients managed through median sternotomy simultaneously (Group I and 111), there were visible blebs or bullous changed lesions mainly in the apicoposterior segment bilaterally in 15 patients (88.2%). Postoperative complications were 3 cases in Group H (wound infection : 2 cases, temporary left wrist drop : one case) but none in Group I and M. Spontaneous pneumothorax recurred in 2 cases, one in Group H and another in Group III but none in Group I.
12 cases of 94 patients(12.8%) who were treated with unilateral thoracotomy needed contralateral thoracotomy mean 14.9 months(7.5-25 months) later. Mean age was 20.9 years(1728).
In conclusion, simultaneous bilateral operation through median sternotomy should be considered in managements of spontaneous pneumothorax, especially in late teens and early twenties except young women for cosmetic reasons.
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