[Results of surgical treatment of persistent or recurrent pneumothorax].
From 1st January 1988 to 31st December 1991, 107 patients were operated on for spontaneous idiopathic (N = 69) or secondary pneumothorax (N = 38). Surgery was performed for recurrence (63.6%) or failure to respond to management by tube drainage (36.4%). Ninety seven patients underwent pleural abrasion, and 10 underwent parietal pleurectomy. Prolonged continuous epidural analgesia was performed in 57 cases. Postoperative complications occurred in 15 patients (14%). Overall morbidity was significantly higher in patients with chronic lung disease (26.3%) than in patients without chronic lung disease (7.2%) (p < or = 0.01). As far as postoperative hospital stay was concerned, the same significant difference was observed (16.8 days versus 12.7 days) (p < or = 0.005). In patients with idiopathic pneumothorax, postoperative hospital stay was significantly shorter in those with epidural pain relief (11.7 days) than in the others (13.6 days) (p < or = 0.025). No recurrence was observed with a mean follow-up of 27 months. We conclude that: 1) surgery is the most efficient treatment of persistent or recurrent pneumothorax; 2) operative morbidity is related to the underlying lung disease and not to the procedure itself; 3) epidural analgesia is beneficial in this surgery.
Thomas
P
P
Service de Chirurgie Thoracique et des Maladies de l'Oesophage, Hôpital Sainte Marguerite, Marseille.
Le Mee
F
F
Le Hors
H
H
Sielezneff
I
I
Auge
A
A
Giudicelli
R
R
Fuentes
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural; D001249:Asthma / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications; D011656:Pulmonary Emphysema / Q000150:complications; D011658:Pulmonary Fibrosis / Q000150:complications; D012008:Recurrence
Résultats du traitement chirurgical des pneumothorax persistants ou récidivants.