Abstract
From February 1993 to December 2011, 35 patients with silicosis underwent surgery to treat secondary spontaneous pneumothorax. These patients were compared to 62 patients who underwent surgery to treat other types of secondary spontaneous pneumothorax in the same period. There were no significant differences in patient characteristics of age, sex, affected side, Hugh-Jones classification, indication for surgery, and the surgical techniques. However, there was a significant difference in the smoking index. Postoperative outcomes revealed no significant differences in the surgical duration, bleeding, duration of drainage, additional treatment, hospital stay, and complications. However, postoperative recurrence occurred in 7 patients with silicosis (20%) but only in 3 patients with other types of pneumothorax (4.8%). This difference was significant. Although the recurrence rate was high, we advocate surgery to treat pneumothorax complicating silicosis, because it can be performed about as safely as surgery to treat other types of secondary pneumothorax. The covering technique involves thickening of the visceral pleura surface. Viewed from the pathological features of silicosis, covering of the visceral pleura may be an important operative procedure for the purpose of preventing postoperative recurrence of pneumothorax complicating silicosis. Further studies of this operative procedure are expected in the future.
