Background: Spontaneous pneumothorax is a common disorder in which treatment strategies are changing.
Material and methods: 220 patients treated at the University Hospital of Tromsø over a 10-year period from 1988 to 1997 were studied. There were 128 patients with primary spontaneous pneumothorax, 51 with secondary spontaneous pneumothorax, and 41 with traumatic pneumothorax. The patients with spontaneous pneumothorax were divided into two groups depending on whether drainage time was less than three days or more. 68 patients were treated with videoassisted thoracoscopic surgery (VATS) or thoracotomy.
Results: Recurrence rate for primary pneumothorax was 19%, for secondary 13% and for traumatic 3%. Recurrence rate for patients having drains for more than three days was lower than the rate for those having drains for a shorter period; 11% and 27% respectively (p < 0.025). Recurrence rates after videoassisted thoracoscopic surgery or thoracotomy were 11% and 4% respectively (p > 0.05).
Interpretation: Although the results are good, the study indicates room for improvement. Drainage time should perhaps be somewhat prolonged when the airleak stops early (< 3 days). VATS should be considered early when there is a persisting leak.