Pneumothorax, persisting in spite of efficient drainage, may in some cases be caused by discrepancy between lung volume and size of the pleural cavity. The logical treatment is reduction of the pleural cavity simultaneously with a traditional surgical procedure on the pulmonary tissue. An increasing number of refractory pneumothoraces--both spontaneous and istrogenic--is probably due to the fact that more people are living with and suffer the sequelae of pulmonary disease. During a 15-year survey a parietal pleurolysis, tailored to fit the size and shape of the lung, was performed in 10 patients as the main surgical procedure in 100 thoracotomies for 1130 cases of spontaneous and 62 cases of iatrogenic pneumothorax. The results were encouraging.
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