[Operative procedure for simultaneous spontaneous pneumothorax].

We have treated 542 cases of spontaneous pneumothorax during the past 20 years, among them 40 cases of bilateral simultaneous spontaneous pneumothorax and 55 cases of non-simultaneous bilateral pneumothorax were included. This paper discusses when the bilateral operation for bilateral simultaneous spontaneous pneumothorax can be carried out and operative approach to bilateral simultaneous thoracotomy. The following results were obtained: Contralateral pneumothorax after an operation for unilateral spontaneous pneumothorax occurred in 25% of teenagers. In cases of spontaneous pneumothorax with occurrence of contralateral pneumothorax, bilateral simultaneous thoracotomy must be performed. In cases of simultaneous spontaneous pneumothorax, we performed simultaneous bilateral thoracotomy, thereby decreasing the psychologic tension of patients and shortening the hospitalization period. The bilateral axillary incision for simultaneous bilateral thoracotomy in cases of simultaneous spontaneous pneumothorax caused least blood loss compared with median sternotomy and transverse bilateral thoracotomy. The transverse bilateral thoracotomy, on the other hand, opens up a larger operating field.