Correlation between recurrent spontaneous pneumothorax and bullas in the lung

Actuality: recurrence of primary spontaneous pneumothorax (PSP) after the first episode of the PSP makes up 62% of all patients with this pathology. Designed surgery for the prevention of recurrence of the PSP can reduce this percentage to 0-25. However, the surgery performed after relapse or after the development of bilateral / contralateral PSP. The pathogenesis of the PSP, although there are alternative theories, usually associated with bullous changes in the lungs. The main methods of identifying effective bull is computed tomography of the chest (CT) and Videothoracoscopy (VTS), but has not been fully determined the best of them. At the same time, is not fully elucidate the effect of the presence of the bull in the relapse CAP. Materials and methods: for 8 years in NMSC of N.I. Pirogov were treated 180 patients with a diagnosis of PSP and its recurrence. In order to confirm the above hypothesis of these patients it was formed three groups to not depend on each other study. One group is to determine the effectiveness of methods of revealing bullous changes, two other bulls to determine the effect on relapse PSP. When the result of the statistical evaluation used Fisher’s exact test, the criterion Mac Nimar, as well as the principle of building the survival curve (outcome-relapse). Results: bullous changes were diagnosed in 74,1% of patients with PSP. CT bullous changes were detected in 65,2%, while the VTS in 79% of patients. The level of recurrence in patients after the first episode of the PSP amounted to 80.4%. In patients with bullous changes identified after the first episode of PSP recurrence occurred in 90.5% of cases and patients without bullae in 64.1%. The median relapse after a first episode of PSP was 4 months. The level of recurrence in patients after surgery was 8.8%. In patients with bullous changes revealed a relapse occurred in 8.5% of cases and patients without bullae 10.5%. In 77.8% of patients relapse occurred in 1 year after surgery. Conclusion: CT is the preferred method for detection of bullous lung changes. Upon detection bullous lung changes, regardless of their size, shown surgery relapse prevention PSP.