Abstract

MEDEROS CURBELO, Orestes Noel et al. Causes and treatment of persistent and recurrent pneumothorax. Rev Cubana Cir [online]. 2008, vol.47, n.1, pp. 0-0. ISSN 1561-2945.

INTRODUCTION. The simple spontaneous pneumothorax is generally caused by the rupture of a small weakened zone of the lung. A recurrent pneumothorax may cause considerable disability. METHODS. A descriptive, prospective and cross-sectional study was conducted among the patients with persistent and recurrent pneumothorax that received attention at "Comandante Manuel Fajardo" University Hospital from 1998 to 2006. The causes of the pneumothorax and the results of its treatment were analyzed. The study group was composed of all the patients with pneumothorax diagnosis (225 patients), of whom those diagnosed with persistent or recurrent pneumothorax (42 in all) were selected. All the patients were attended by following a working algorithm of surgery service of the hospital. RESULTS. The bullae were the main cause of the recurrent pneumothorax, and the subpleural vesicles of the persistent. In the persistent pneumothorax, the aspiration probe was maintained until the fifth day in 71 % of the cases, from 5 to 7 in 23 %, and for more than 7 days in 6 %. The axillary route was used for the incision, and atypical or regulated resection was performed with parietal pleurotomy or abrasion, which had 100 % of effectivity. No surgical mortality was reported. CONCLUSIONS. The care of the pleurotomy catheter and the continual controlled aspiration are milestones in the primary treatment of pneumothorax. After 5 days without attaining the pulmonary reexpansion, and if there is a second pneumothorax, the definitive treatment by thoracotomy should always be assessed. Parietal pleurotomy should be considered as an elective procedure in the patients with an adequate respiratory reserve. A good drainage aspiration system prevents a second intervention and reduces the possibilities of complications

Keywords : Persistent pneumothorax; recurrent pneumothorax; treatment.

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