We have observed 101 cases of recurrent spontaneous pneumothorax from Sep. 1979 to Dec. 1989 at the department of Thoracic & Cardiovascular Surgery, College of Medicine, Inje University, Pusan Paik Hospital and the result obtained as follows.
1) Age range of patients was the first decade to seventh decade. Males outnumbered females by 6.7 : 1. One or two episodes of recurrent attack were noted in majority cases.
2) In dis-, ribution of the lesion sites, right side was 55 cases (55.4%), left 42 cases (41.9 %), and bilateral 4 cases(3.0%).
3) In clinical manifestions, abrupt onset of dyspnea was 78 cases(77.2%), chest pain 48 cases (47.5%), cough 9 cases (8.9%) and chest discomfortness 8 cases (7.9%).
4) Of 101 cases, 48 cases were associated with pulmonary tuberculosis and other cases were associated with subpleural bullae and blebs (26 cases), emphysema (7 cases), bronchiectasis(2 cases), lung cancer (I case), and silicosis (1 case).
5) In 88 cases(87.2%) of patients, the magnitude of collapse was above 50% in plain chest film.
6) The interval of recurrence after last attack was frequently within 1 year.
7) In the management, closed thoracostomy with underwater-sealed drainage was ;applied in first recurrent 53 cases but 2nd recurrence was developed in 16 cases. In 52 cases, surgical management was applied. The pleurodesis with chemical agent (tetracycline) via chest tube was applied in 2 cases. Among 51 cases subjected to the open thoracotomy, pleural abrasion was performed in 3 cases, excision of bullae & blebs in 12 cases, wedge resection in 28 cases, lobectomy in 6 cases and wedge resection combined with lobectomy in 2 cases. In one case subjected to the median sternotomy, wedge resection on both lung apex was performed.
8) Postoperative complications were developed in 8 cases but not serious.
|