To prevent recurrence of spontaneous pneumothorax, 23 patients were operated through median sternotomy for simultaneous resection of bilateral bullae. And 27 patients with spontaneous pneumothorax were treated with unilateral thoracotomy, We
studied the
number, duration and sites of recurrence including findings of CT scan, as well as comparing the both operated group.
The incidence of spontaneous pneumothorax was 88% in patients with the ages between 16 to 35. Forty one patients(82%) were operated with the indication of recurrent pneumpthorax. The number of pneumothorax attach was 2.34 per patient with
recurrent
pneumothorax. The 87.8% of recurrence was occured within 6 months from last attack. Ipsilateral recurrnet pneumothorax was 56.1% and contallateral involve was 43.9%. The bilaterality of visible bullae was 90.9% in the findings of chest CT scan
and
91.3%
in the operative finding. The sensitively and accuracy for bulla detection with chest CT were CT were 92.3%, respectively. Exclude one case of complicated median sternotomy infection, the postoperative hospital stay was shorter in median
sternotomy
approached group(P<0.05).
In conclusion, the bullous lesions of the lung have tendency of bilaterality so that median sternotomy for simultaneous resection of bilateral bullae should be considered in patients with contralateral visible bullae with chest CT.
|