One hundred and thirty-one cases of spontaneous pneumothorax from 1972-1979 were evaluated clinically the literature reviewed.
The yearly incidence of spontaneous pneumothorax has been increasing gradually. The highest incidence was in the 20-29 age group, and the overwhelming majority of the cases were males (91.8%). The affected side was the right in 54, left in 59 and bilateral in 24 cases including 9 of simultaneous onset. The initial symptoms were chest pain (70.2%) and dyspnea (38.9%). Physical activity at the time of onset was not characteristic in the history of the condition: at rest (59.0%), during exercise (27.0%), on coughing (6.6%) and unknown (7.4%). Of 131 cases, 72 were initial and 59 were recurrent. The duration to relapse was within a year in 72% of the 59 cases.
In examining the relation between previous treatment and recurrence, there was a remarkably high risk of recurrence (79.6%) if the only treatment had been bed-rest or simple needle aspiration therapy. The recurrence rate was less frequent (27.9%) in tube drainage cases. The lowest recurrence was noted in 74 thoracotomized cases with a recurrence of 1.3%.
Considering the high incidence of recurrence in patients treated with conservative therapies, the importance of a more radical therapy, thoracotomy, should be emphasized as the treatment of choice in the management of spontaneous pneumothorax.
