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Entre enero de 1983 y julio de 1984 hemos analizado la presencia de bullas en pacientes con neumotórax espontáneo (NE), formando dos grupos de pacientes. El grupo A constituido por los NE recidivantes que han sido toracotomizados, 24 toracotomias (bullas en el 91,6%) y en grupo B utilizado como control, formado por los pacientes con NE a los que se les practicó toracoscopia diagnóstica en el primer episodio, 21 pacientes (bullas en el 51,7%). Encontrando, que la presencia de bullas es una causa, estadísticamente significativa, de la recidiva del NE (X2:7,2, p < 0,01), siendo ésta independiente del tratamiento con reposo o drenaje cuando las bullas estuvieron presentes (X2:0,003, p:NS) y sólo la realización de una toracotomía fue eficaz para evitar la recidiva (100%).
Basándonos en estos resultados proponemos la realización de una toracoscopia diagnóstica en el primer episodio de NE a aquellos pacientes que previamente no presenten indicación o contraindicación quirúrgica, efectuándose toracotomía a aquellos que presenten bullas.
Between January 1983 and July 1984 the authors analyzed the incidence of bullas in patients with spontaneous pneumothorax (SP) by forming two groups: group A with patients with recurrent SP who underwent thoracotomy (24 thoracotomies; 91.66% bullas) and group B with 21 patients with SP who underwent diagnostic thoracoscopy during the first episode (bullas in 57.1%) who were used as the control group. The presence of bullas was a statistically significant cause for recurrence of the SP (X2:7.2, p < 0.01) independent from the mode of treatment (rest or drainage) when the bullas were present (X2:0.003, p:SP) and only thoracotomy proved successful in avoiding recurrence of the SP (100%).
Because of these findings, the authors recommend a diagnostic thorascopy during the first episode of SP in patients without previous indication or contraindication for surgery followed by thoracotomy if bullas are present.
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