Abstract
A tall 13-year-old male with simultaneous bilateral pneumothoraces underwent bilateral partial lung resections. Visceral pleural coverage with an oxidized regenerated cellulose sheet was applied to prevent recurrence. He was discharged 3 days after surgery, and was reffered to another institution for genetic analysis for suspected Marfan syndrome. Four months after the surgery, the patient presented to our hospital with sudden-onset chest pain. A chest radiograph revealed recurrent simultaneous bilateral pneumothoraces, and re-operation was carried out. Bullae regrowth along the staple lines was seen bilaterally, and were found to be responsible for the recurrence. No thickenings of visceral pleura were found within the area covered in the first operation. We performed bilateral partial lung resections and a covering technique with polyglycolic acid sheets. He has been recurrence-free for 21 months since the second surgery, and was genetically confirmed as having Marfan syndrome. We consider that the covering technique with an oxidized regenerated cellulose sheet is unfavorable for high-risk patients, like the present case. A large-scale comparison between the use of oxidized regenerated cellulose and polyglycolic acid is needed to resolve this issue.
