Kocaeli Üniversitesi Tıp Fakültesi Hastanesi Kalp Ve Damar Cerrahisi AD, Kocaeli

BACKGROUND: We aimed to present our experiences in axillary thoracotomy (AT) and video assisted thoracoscopic surgery (VATS) in patients with spontaneus pneumothorax and to discuss the reasons of our choosing of AT. MATERIAL-METHOD: Between February 2003 and April 2005, 37 patients with spontaneus pneumothorax (SP) were treated in Thoracic Surgery Department of Kocaeli University Hospital were included in the study. The age, gender, etiology, indications for surgery, the surgical procedures, involved hemithorax and the postoperative complications of each patient were investigated retrospectivly. RESULTS: Twenty-one patients (56.7%) were primary spontaneus pneumothorax and 16 (43.2%) were secondary spontaneus pneumothorax. Six (16.2%) patients were treated conservatively whereas tube thoracostomy were applied to the rest. One (2.7%) patient in his first episode was operated. In eleven (29.7%) patients recurrency were observed. Four (36.3%) patients with recurrent pneumothorax were operated. In the follow-up of the remaining seven (63.7%) patients; secondary recurrency were seen in 3 (42.8%) patients and two (66.6%) of these patients were operated. In six patients (85.7%) bullae ligation and mechanical abrasion via axillary thoracotomy were performed. In the remaining patient bullae ligation and mechanical abrasion were performed via VATS. No postoperative complication was detected. CONCLUSION: The primary treatment modality for spontaneus pneumothorax is conservative treatment or the thoracotomy depending on the degree of pneumothorax. Axillary thoracotomy must be preferred due to the lower cost and patient comfort.