In this study, 612 cases of spontaneous pneumothorax experienced at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital during from January, 1984 to September, 1993 were analyzed retrospectively.
The age of patients ranged from neonate(2 days old) to 86 years old. The ratio of male to female was 6.28:1, predominant in male.
The most common chief complaints were chest pain and dyspnea.
The site of pneumothorax was right in 52.2%, left in 45% and bilateral in 2.8%.
The associated pulmonary lesions were tuberculosis, active or healed in 179 cases(29.2%), COPD in 42 cases(6.8%), COPD with pulmonary tuberculosis history in 14 cases(2.3%), bronchial asthma in 12 cases(1.9%), lung cancer in 7 cases(1.1%),
Paragonimiasis westermani in 3 cases, pneumoconiosis in 4 cases, and other diseases in 12 cases and unknown underlying pathology in 329 cases(53.8%).
The frequency of recurrence was as follows; first in 435 cases(71.1%), 2nd in 135 cases(21.9%), 3rd in 31 cases(5%), 4th in 7 cases(1.1%), 5th in 3 cases, 6th in 1 case.
The methods of treatment were as follows; observation in 4 cases, thoracentesis in 5 cases, closed thoracostomy in 586 cases, open thoracotomy in 143 cases(23.3%).
The open thoracotomy was performed in 143 cases and operative procedures were as follows; bullectomy or wedge resection of lung through the thoracotomy in 128 cases, lobectomy in 6 cases, pneumonectomy 1 in cases, and bullectomy by VATS in 8
cases.
The significant complications of closed thoracostomy were as follows; empyema thoracis in 8 cases(1.3%), pulmonary edema in 4 cases(0.7%), and bleeding in 4 cases(0.7%).
The mortality rate during the treatment of pneumothorax was 0.6% and cause of death was respiratory failure due to underlying lung disease. (Korean J Thoracic Cardiovas Surg 1993;26:866-70)
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