Linchevskyy O. Diagnosis and management of spontaneous pneumothorax

The goal of this work is to improve the efficacy of management of spontaneous pneumothorax by establishing criteria of recurrence, and performing the life tissue welding method in surgical management of spontaneous pneumothorax. Data of 723 consecutive patients with spontaneous pneumothorax were analyzed. Among them, 625 have primary, 93 - secondary pneumothorax, 4 died patients and 1 with pneumothorax of a single lung were discussed separately. In the first study, we analyzed retrospectively the data of patients with first occurrence of pneumothorax. We were focused on CT and thoracoscopic differences between a group of 73 patients, those had never pneumothorax recurrence, and another group of 50 patients with pneumothorax recurrences during the follow up period for 5 years. All of them were managed in our institution. Data from direct (medical) thoracoscopy a computed tomography were collected. We found a correlation between size of bullae seeing during the first occurrence and probability of pneumothorax recurrence. In patients with recurrent pneumothorax bullae over 1 cm in diameter are observed in 38% on thoracoscopy and 36% on CT versus 16% and 11% respectively in patients without recurrences. Result was statistically proven.