Bilateral Therapy for Unilateral Spontaneous Pneumothorax

Is prophylactic treatment of contralateral blebs in patients with primary spontaneous pneumothorax indicated?

“…23 Actually, bilateral surgery for unilateral PSP was advocated by Baronofsky 50 years ago. 24 In this study, we noticed that bilateral surgery under the same anesthesia for patients with unilateral PSP has no increased risk. The pain in VAS is a little greater, but of little significance.…”

Simultaneous bilateral thoracoscopic blebs excision reduces contralateral recurrence in patients undergoing operation for ipsilateral primary spontaneous pneumothorax

“…International consensus recommends surgical intervention after the first ipsilateral or contralateral recurrence, as mentioned in the leading guidelines. 2,14,15 Although some literature advocates early surgery for patients presenting with blebs or bullae after a first episode of PSP, 4,[16][17][18] as well as some physicians proving the feasibility and safety of performing single-stage unilateral or bilateral video-assisted thoracic surgery (VATS) in selected patients with PSP with contralateral blebs/bullae using different techniques, [19][20][21][22][23][24] the effect of contralateral bleb excision in the prevention of contralateral recurrence with the same anesthesia for ipsilateral PSP remains controversial. No study or follow-up data show the outcome or effect of the contralateral surgery.…”

Comparison of single-stage and two-stage bilateral video-assisted thoracic surgery

“…Single-stage bilateral thoracotomy for spontaneous pneumothorax was first introduced in 1957 18 and has been suggested for prophylactic treatment of contralateral pneumothorax. 6,19 Theoretically, singlestage bilateral pulmonary resection also decreases the risk of disease progression, especially in patients with bilateral malignant tumors; shortens the patients' total hospitalization time; and decreases postoperative complications.…”