Simultaneous bilateral bleb resection was done through bilateral trans-axillary thoracotomy in 10 patients with spontaneous pneumothorax during the period from May 1991 to Novemver 1992 in whom bilateral bulla or bleb was detected with using
simple
chest X-ray and chest CT scanning.
To compare the effectiveness of bilateral trans-axillary thoracotomy, we investigated 10 unilateral trans-axillary thoracotomy patients with spontaneous pneumothorax and two clinical reports from other institutes which dealt the results of
bilateral
bleb or bulla resection through median sternotomy also.
In bilateral trans-axillary thoracotomy group, mean operation the was 115 minute, mean intraoperative bleeding was 329 cc, mean postoperative hospital stay was 7.5 days. Postoperative ABGA(Arterial Blood Gas Analysis) was in normal range and
postoperative recovery rater of FVC(Forced Vital Capacity), FEV1(Forced Expiratory Volume at 1 second). TV(Tidal Volume) were 84.3%, 93.4%, 88.7%, respectively. In median sternotomy group, mean operation time was 129 minute, mean intraoperative
bleeding
was 490cc, mean postoperative hospital stay was 12.4 days. Postoperative ABGA was in normal range and postoperative recovery rates of FVC, FEV1 were 97.3%, 97.4%, respectively. In unilateral trans-axillary thoracotomy group, postoperative ABGA
was
in
normal range also and postoperative recovery rates of FVC, FEV1, TV were 91.6%, 99.0%, 96.0%, respectively.
In conclusion, simultaneous bilateral bleb resection through bilateral trans-axillary thoracotomy should be considered in pneumothorax patients with bilateral bleb or bulla because of cost-effectiveness(reducing hospital days) and better cosmetic
result
without any impairment in recovery of respiratory function. (Korean J Thoracic Cardiovas Surg 1994; 27:54-58)
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