[Structural anomalies in lung apices after pneumothorax operation].
BACKGROUND
Fifty-eight patients (mean age 27 years, range 17-44) with primary spontaneous pneumothorax (PSP) underwent resection of apical bullae and partial apical pleurectomy via mini-thoracotomy or thoracoscopy, in 12 cases bilaterally, between 1982 and 1999.


METHODS
After a mean follow-up period of 111 (16-212) months, 26 patients with 31 operated lungs were reassessed by high-resolution CT (HRCT) to demonstrate postoperative morphological changes.


RESULTS
Neither relevant clinical symptoms nor recurrence of a pneumothorax were found. However, HRCT revealed new apical bleb formations in 22 (71%) of 31 lungs. Neither the surgical approach, the technique of resection nor giving up smoking could be correlated to the tissue alterations. Surgical excision of the apex of the lung does not stop bleb formation.


CONCLUSIONS
This study confirms earlier results from a different institution, when blebs recurred in 50% of the cases. The presence of these new apical formations neither influenced the clinical outcome nor predisposed to recurrence of PSP. Parietal (partial) pleurectomy seems mandatory to prevent PSP in the long-term.
Fackeldey
V
V
Abteilung für Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus, Rübenacherstrasse 170, 56072 Koblenz.
Schöneich
R
R
Otto
A
A
Schmitt
B
B
Franke
A
A
Gatzka
F
F
Becker
H P
HP
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010994:Pleura / Q000000981:diagnostic imaging / Q000601:surgery; D011013:Pneumonectomy; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed
Strukturanomalien im Lungenspitzenbereich nach Pneumothoraxoperation.