[Minor thoracotomy for the treatment of spontaneous pneumothorax].

We have recently established the following therapeutic principles for spontaneous pneumothorax, and have obtained favorable results. 1. All patients, including those with a first episode, are subjected to thoracotomy. 2. The standard technique is minor thoracotomy through a skin incision of 5 cm which is aesthetically superior, except complicated cases with chronic obstructive lung disease in elderly patients or giant bullae. 3. Bilateral simultaneous axillary minor thoracotomy is applied to bilateral pneumothorax, whether synchronous or metachronous. 4. Thoracotomy is attempted by other approaches when we preoperatively suspect pulmonary bullae in the lung bases or diaphragm. In the past three years (1988 to 1990), 68 out of 70 cases (97.1%) of spontaneous pneumothorax admitted to our department were operated on. Of them, 55 cases (81% of all surgical cases) underwent minor thoracotomy. Pleural abrasion was performed in order to prevent postoperative recurrence of the pneumothorax. The 55 cases of minor thoracotomy consisted of 51 males and 4 females aged 27.6 years on average (range: 15 to 64). In 22 cases (40%), this was the first occurrence, combination with hemothorax was seen in 4 cases, and bilateral simultaneous axillary minor thoracotomy was performed in 11 cases (20%). The location of the bullae was the upper lobe (or upper segment) in 95.5%, the middle lobe (or lingula) in 6%, and the lower lobe (S6) in 20%.(ABSTRACT TRUNCATED AT 250 WORDS)