Diagnosi e trattamento del pneumotorace secondario

Aim. Personal experience over a 5-year period in the treatment of secondary pneumothorax is reported, and the methodologies that, in the light of the most up-to-date technologies, have been adopted are underlined. Methods. A total of 29 patients (21 males and 8 females) aged from 18 to 77 years (mean age 56), have been treated. Left localization was present in 18 cases (62%) and on the right in 11 (38%). In all these patients an endopleural drainage connected with a water valve has been performed as emergency procedure. Results. The placement of an endothoracic drainage was the final treatment in 7 patients (25%). Complications or operative mortality have not been observed and drainages have been removed after 4 to 9 days. The chemical pleurodesis or with talc, if endopleural aspiration alone is not sufficient to control the air loss, was successful in 27% and 7% of the cases, respectively. Moreover, no complications or operative mortality have been observed also in patients submitted to video-assisted thoracic surgery or thoracotomy, and drainages have been removed by day 10 from intervention. The results obtained from this survey show the good percentage of success and the absence of recurrences. Conclusion. The placement of an endothoracic drainage is considered an emergency treatment and conservative therapy should be carried out only in cases of not important pneumothorax or in seriously ill patients who cannot undergo surgery.