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Vol. 30. Issue 7.
Pages 344-347 (August - September 1994)
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Vol. 30. Issue 7.
Pages 344-347 (August - September 1994)
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Tratamiento del neumotórax espontáneo en pacientes mayores de 70 años
Treatment of spontaneous pneumothorax in patients over 70
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J. Loscertales*, F. García Díaz, R. Jiménez Merchán, F.J. Ayarra, C. Arenas Linares, J.C. Girón Arjona
Servicio de Cirugía General y Torácica. Cátedra de Cirugía. Hospital Universitario de Sevilla. Sevilla
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Se presentan 48 pacientes mayores de 70 años afectados de neumotórax espontáneo (NE). La gravedad del cuadro clínico está condicionada por las lesiones previas pulmonares, sobre todo el enfisema, y el grado de insuficiencia respiratoria anterior al episodio de neumotórax.

Se indican las pautas de tratamiento seguido, que incluyen drenaje pleural aspirativo, realizado en todos los casos, con un fracaso del 69%. La pleurodesis con tetraciclina se practicó en 23 pacientes, con un 35% de fracasos. El talcaje por toracoscopia se llevó a cabo en 5 pacientes, no siendo resolutivo en uno. La cirugía endoscópica videoasistida se realizó en 4 pacientes, con buenos resultados en tres de ellos. La cirugía reglada mediante toracotomía lateral se practicó en 20 casos con un solo fracaso justificado por las circunstancias del paciente.

Forty-eight patients over the age of 70 with spontaneous pneumothorax (SP) are analyzed. The severity of the clinical picture is conditioned by the presence of earlier lung lesions, particularly related to emphysema, and by the degree of respiratory failure prior to SP.

Treatment guidelines are listed. Pleural drainage/aspiration, applied in all cases, was of no avail in 69%. Tetracycline was injected into the pleural space of 23 patients, with failure recorded in 35%. Talc was applied by thoroscopy in 5 patients, to no avail. Video-assisted endoscopic surgery was carried out in 4 patients, with good results in 3. Surgery with access by lateral thoracotomy was carried out in 20 patients, with a single failure that was explained by the patient's condition.

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Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
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