Abstrakt: |
Spontaneous pneumothorax is a frequent affliction. The primary type principally affects males in the third decade of life, while the secondary type affects elderly patients with lung disease. When reviewing the cases of pneumothorax registered by the Thoracic Surgery Unit of the Hospital of Navarra, we found an incidence similar to other countries in our geographic area, and a biphasic distribution of the disease with the incidence peaks in youth and old age that we have mentioned. The disease is more frequent in males, smokers, and during the winter months. An account is given of the physiological mechanisms responsible for the formation of bullas in puberty. The first step in treatment is pleural drainage, the aim of which is to achieve pulmonary re-expansion and the re-establishment of the integrity of the visceral pleura. Although there are controversies regarding the definitive treatment, we carry out surgical resection of the pulmonary bullas in cases of relapse or when the CAT indicates a high risk of relapse, or resection of the pulmonary vertex following a second episode in spite of the non-existence of lesions in the CAT. We do not carry out pleurodesis, except in elderly patients who are not susceptible to surgery. Our results are similar to those obtained by other groups with respect to relapses, low morbidity and nil mortality in primary spontaneous pneumothorax. |