Bilateral Primary Spontaneous Pneumothorax Research Articles

The Descriptive Features of Primary Spontaneous Pneumothorax Patients in King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Background Primary spontaneous pneumothorax (PSP) is a fairly prevalent disorder in emergency medicine. PSP most frequently affects tall, thin male smokers and is most prevalent during adolescence. Published literature contains a wide range of Primary Spontaneous Pneumothorax (PSP) recurrence rates, but there is limited information on the variables affecting recurrence. Objective To identify the descriptive features of PSP in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods This retrospective cross-sectional study was conducted in Surgery King Abdulaziz Medical City, Riyadh, Saudi Arabia. Including all PSP patients from 2016-2021, excluding pediatric and geriatric patients. Participants were selected using a simple random sampling technique, and data were collected from hospital records. Data analysis was conducted by using SPSS. Results In this study, we included a total of 131 participants. Most were males (93.1%), and most were aged between 21-30 years. Our findings showed that most PSP events occurred in winter (28.6%). Followed by fall (25.7%), summer (25.0%), and spring (20.7%). Concerning the smoking status of our respondents, our results revealed that most of them were active smokers (72.5%). Left-PSP was the most commonly reported type of PSP (43.5 %), followed by right-PSP (38.9%), non-simultaneous bilateral PSP (14.5%), and bilateral simultaneous PSP (3.1%). Moreover, we found that the recurrence rate of PSP was 42%. Regarding the management of PSP, almost half of the respondents were managed initially by Chest tube. The most frequently used surgical option was VATS- Bullectomy with Abrasion Pleurodesis. Finally, the recurrence rate of PSP was 42% among the patients. The percentage of patients with one recurrence only was 65.5% among the patients with recurrent PSP, second recurrence at 29.1%. Third, Fourth, and Fifth had the same recurrence percentage of 1.8%, and these percentages came to be statistically significant. (P value < 0.001) Conclusion Our study concluded that PSP was more prevalent in tall, thin, young male smokers. Almost half of the respondents suffered from at least one recurrence attack of PSP. The majority of the patients with recurrences experienced one recurrence only, and the second recurrence was estimated to be almost one-third. There is no significant association between the occurrence and seasons of the attack at a time. Most of the participants were managed initially by a chest tube. The most frequently used surgical option was Video Assisted Thoracoscopic Surgery (VATS) with abrasion pleurodesis.

Simultaneous Bilateral Primary Spontaneous Pneumothorax (SBPSP) in a young male athlete: A rare presentation

Simultaneous Bilateral Primary Spontaneous Pneumothorax (SBPSP) in a young male athlete: A rare presentation

P12‐38: A young woman with bilateral primary spontaneous pneumothorax

P12‐38: A young woman with bilateral primary spontaneous pneumothorax

A left lung with four lobes: a new discovery during the thoracotomy for recurrent primary spontaneous pneumothorax

BackgroundThe right and left lung anatomy are similar but asymmetrical. The right lung consists of three lobes, and the left lung consists of two lobes. Our study is unique because of discovering a very rare morphological feature of the left lung which has not been reported yet. By the way, we compared two different available chemical agents for pleurodesis (talc and bleomycin) according to side effects, complications, and pneumothorax recurrence.Case presentationWe reported a case of bilateral primary spontaneous pneumothorax, who underwent talc slurry and bleomycin pleurodesis at right and left side retrospectively, and then complicate with left-sided recurrent spontaneous pneumothorax, so underwent open thoracotomy and was surprisingly and accidentally found to have 4 lobes and 3 fissures in left lung.ConclusionIn our case report, there were one main oblique fissure and two accessory fissures which divided the lung into 4 separated lobes, and this discovery in human’s and other animals’ lung anatomy has not been previously reported. In our case study, the talc slurry was more effective in preventing spontaneous pneumothorax recurrence, but with more side effects than bleomycin. We could hypothesize that the morphological variation of the lung might affect spontaneous pneumothorax development and recurrence.

Bilateral primary spontaneous pneumothorax with multiple bleb performed by VATS and wedge resection: A rare case in Indonesian adult and review article.

BackgroundBilateral primary spontaneous pneumothorax (PSP) is a rare case of lung disease.Case presentationA 20-year-old man with a complaint of shortness of breath is suspected of having PSP and tuberculosis. The patient underwent water seal drainage installation in both lung cavities, but showed no improvement. Multiple blebs were found after a few days. A wedge resection with VATS became an option. The patient had improved lung function after the procedure.DiscussionThe WSD installation showed lungs improvement. However, when trained for lung expansion, the lung condition became bad. After wedge resection with the help of VATS on multiple blebs, the lung had a significant improvement.ConclusionWedge resection could be considered in PSP patients with multiple blebs.

心肺停止で搬送された両側緊張性気胸の14歳男児の1例(A case of 14–year–old boy with cardiopulmonary arrest caused by simultaneous bilateral primary spontaneous pneumothorax)

要旨 自然気胸の多くは片側であり重症例は少ない。しかし緊張性気胸および両側気胸は診断および介入が遅れると致死的となりうる。我々は，発症から1時間も経たないうちに心肺停止となり救急搬送された両側緊張性気胸の14歳男児の症例を経験した。本例では心肺蘇生により自己心拍は再開したが，頻脈・低血圧が遷延し，胸部X線写真で両側緊張性気胸と診断し胸腔ドレナージを行った。しかし，直後に撮影した頭部CTで低酸素脳症を呈し，その後意識障害が遷延し自発呼吸はなく，第12病日に平坦脳波を確認し，最終的にPCPC（pediatric cerebral performance category）6となった。両側気胸は気管支喘息発作と混同されやすく，アナフィラキシーも合わせて鑑別する必要がある。緊張性気胸には片側だけでなく，稀に両側があり，その診断は身体所見のみでは困難なため，近年有用性が報告されている超音波検査を併用し，可及的速やかに胸部X線写真を撮るべきである。

Surgery for simultaneous bilateral primary spontaneous pneumothorax: when and how?

Although primary spontaneous pneumothorax (PSP) is common in adolescents and young adults, simultaneous bilateral primary spontaneous pneumothorax (SBPSP) is an unusual and potentially life-threatening condition with limited data on its incidence in the literature. There are evidence-based guidelines for the management of PSP, whereas the specific treatment strategy is not clearly defined in SBPSP despite clinical practice recommendations that surgery should be offered at the first episode. Currently, for most thoracic surgeons worldwide, video-assisted thoracic surgery (VATS) has taken a leading role in the treatment of PSP, due to its well-known advantages including less pain, better cosmetics, and faster recovery. In this article, we aim to explore the aspects of epidemiology, pathophysiology, diagnosis, management, and evolution of surgical approaches related to SBPSP.

Unilateral single-port thoracoscopic surgery for bilateral pneumothorax\xa0or\xa0pulmonary bullae

BackgroundRapid rehabilitation surgery has become a widely accepted approach. Thoracic surgeons have attempted in many ways to make surgery less invasive. We combined tubeless technology, single-port technology and mediastinum approach for the treatment of simultaneous bilateral primary spontaneous pneumothorax(PSP)or pulmonary bullae. And we evaluated its therapeutic effect. This study aimed to investigate if tubeless single-port video-assisted thoracic surgery (Tubeless-SPVATS) via anterior mediastinum can be used as an alternative surgical treatment for bilateral lung diseases, especially for concurrent or contralateral recurrence PSP.MethodsFrom November 2014 to December 2016, 18 patients with simultaneous bilateral PSP or pulmonary bullae were treated with tubeless -SPVATS via anterior mediastinum. They were 13 males and 5 females with an average age of 20.2 ± 2.3 years (17 to 24 years). They all had preoperative chest CT and were diagnosed with simultaneous bilateral PSP or pulmonary bullae.ResultsFifteen patients underwent bilateral bullae resection with Tubeless-SPVATS via anterior mediastinum. Three patients underwent bilateral single-port video-assisted thoracic surgery. No thoracotomy was performed. No death and grade 3-4 mobidity were found. All the patients started eating 6 hours after surgery. The average operation time was 44.56±17.8min. The patients were discharged 3. 5±1.0 days postoperatively.ConclusionsTubeless-SPVATS via anterior mediastinum is a safe and feasible treatment for patients with simultaneous bilateral PSP or pulmonary bullae. However,contralateral thoracic is not explored fully enough. And when contralateral lung bullae are located near the hilum, endoscopic linear stapler cannot be easily used to conduct suture. Thus, the recurrence rate after performing Tubeless-SPVATS may be increased compared to performing thoracotomy. However, compared to bilateral thoracic surgery, this method reduced postoperative pain. And it took significantly less time than bilateral thoracic surgery. Thus, this method has some clinic value.

A Mysterious Case of Spontaneous Cervical Epidural Hematoma and Bilateral Primary Spontaneous Pneumothorax caused by a Rare Etiology.

ABSTRACTSpontaneous spinal epidural hematoma (SSEH) is a rare disorder that can present as an acute onset of pain and radicular symptoms that mimic disk herniation. Primary spontaneous pneumothorax (PSP) can be defined as presence of air in the pleural space without apparent underlying lung disease or trauma. We describe a rare case of SSEH in cervical spine (C5–7) presenting with a novel association, a bilateral PSP, which has never been documented before. Both SSEH and spontaneous pneumothorax, though rare, can be associated with vasculopathy and our patient had signs of vasculopathy of intracranial vessels and pulmonary vasculature. Vasculopathy also needs to be considered while evaluating a case of PSP without emphysema-like changes (ELCs) and if diagnosed as the cause, pleurodesis could be considered as a part of the management to avoid the sequel of recurrent pneumothorax and prolonged ICU stay in this subset of patients.How to cite this article Thakkar K, Ajayan N, et al. A Mysterious Case of Spontaneous Cervical Epidural Hematoma and Bilateral Primary Spontaneous Pneumothorax caused by a Rare Etiology. Indian J Crit Care Med 2019;23(4):186–187.

Single-staged uniportal VATS in the supine position for simultaneous bilateral primary spontaneous pneumothorax

BackgroundSimultaneous bilateral primary spontaneous pneumothorax (SBPSP) is rare, but requires surgery on both sides, in patients with definite bilateral bullae to prevent life-threatening conditions. Recently, uniportal video-assisted thoracoscopic surgery (VATS) has been widely accepted as a less invasive technique for the treatment of pneumothorax. Thus, we introduced single-staged uniportal VATS technique in the supine position, for the management of two cases of SBPSP.Case presentationA 17-year-old boy presented with bilateral spontaneous pneumothorax and he underwent single-staged uniportal VATS in the supine position. Single wide draping in consecutive bilateral approaches removes the needs of changing patients’ position. Whole thoracoscopic procedure for wedge resection of bullae lesions was conducted without difficulty. The total operation time took 65 min and the patient discharged 3 days after the operation. The patient was followed for 24 months without recurrence of both sides. Another 18-year-old boy was admitted with bilateral spontaneous pneumothorax and single-staged uniportal VATS was also performed in the supine position. The total operation time took 79 min and the patient discharged on postoperative day 4. He was followed for 19 months without recurrence of both sides.ConclusionsSingle-staged uniportal VATS approach yielded satisfactory results from simplicity that not requires position change compared to conventional multi-ports VATS in the lateral position, and with better cosmetics. This technique is thought to be a feasible procedure in selective patients with SBPSP or with contralateral bullae for preventive role.

Primary spontaneous pneumothorax: simultaneous treatment by bilateral non-intubated videothoracoscopy.

Through a retrospective study, we assessed the feasibility and safety of simultaneous bilateral thoracoscopic wedge resection of blebs or bullae for the treatment of primary spontaneous pneumothorax (PSP) under thoracic epidural anaesthesia with spontaneous ventilation. This retrospective analysis involved a cohort of 37 consecutive patients undergoing simultaneous bilateral thoracoscopic bullectomy under spontaneous ventilation thoracic epidural anaesthesia (n = 15) or intubated general anaesthesia (n = 22) between July 2011 and September 2015. The perioperative data, short-term outcomes and recurrence rates of the two groups were compared. The two groups had comparable preoperative demographic profiles. There were no conversions to thoracotomy or intubated single-lung ventilation. The peak end-tidal carbon dioxide in the non-intubated group was significantly higher than that in the intubated group (mean: 48 vs 34 mmHg, P < 0.001). Both groups had comparable surgical duration, blood loss and lowest intraoperative pulse oxygen saturation level. Postoperatively, the two groups had comparable chest tube duration, volume of fluid administration, length of hospital stay and complication rates. No mortality occurred. The total anaesthesia cost in non-intubated group was significantly lower (mean: CNY 4584 vs 5649, P = 0.016). The mean follow-up was 23.6 ± 12.9 months in the non-intubated group and 21.1 ± 13.4 months in the intubated group. Two recurrent pneumothoraxes in 2 patients were observed after surgical procedures for PSP. One recurrence developed in the non-intubated group (7%) and one in the intubated group (5%). Simultaneous bilateral non-intubated thoracoscopic bullectomy is not only well tolerated and technically feasible but also a safe alternative for selected patients with simultaneous bilateral PSP or with high risk of contralateral recurrence.

Otozomal Resesif Olarak Aktarılan Ailesel Primer Spontan Pnömotoraks: Sık Akraba Evlilikleri Yapmış Geniş Bir Aile

Objective: The objective of this study is to determine the clinical and hereditary characteristics of Familial Primary Spontaneous Pneumothorax (FPSP) observed in a number of individuals within a large family. Material and Methods: In the medical history of the patient, WHO applied to the Emergency Department due to a severe difficulty in breathing and was diagnosed with a bilateral Primary Spontaneous Pneumothorax (PSP) and received a bilateral tube thoracostomy performed by the pediatric surgery clinic, it was determined that there were 8 individuals in his family circle who had been affected by PSP disease. All the demographic, clinical, laboratory, radiological, and hereditary data of these individuals were collected. Results: In the physical examination of the patients, there were incisional scars of tube thoracostomy and/or thoracoscopy and/or thoracotomy over the rib cages of 6 cases. While the other system examinations and laboratory findings were normal of all patients, seven of the cases have radiological changes at low- and mid- levels - in the lungs in the thoracic computerized tomography. Based on the drawn family tree, we suggest that the FPSP in this family occurred through autosomal recessive heredity. Conclusion: We believe that the PSP seen in this family is familial and transferred through autosomal recessive inheritance and the common consanguineous marriages within the family plays a role in the intensity of the disease. Further research on molecular level is required in order to better understand the precise genetic reasons that are lying under the developed FPSP disease of these eight patients.

A Case of Spontaneously Resolved Bilateral Primary Spontaneous Pneumothorax

A Case of Spontaneously Resolved Bilateral Primary Spontaneous Pneumothorax

Eşzamanlı Bilateral Primer Spontan Pnömotoraks Olgusu

Primary spontaneous pneumothorax is probably appeared by collection of air because of rupture of an apical subpleural bulla or bleb. Simultaneous bilateral primary spontaneous pneumothorax seem at the same time is rare and life threatening condition. Here we presenting a case of bilateral primary spontaneous pneumothorax who applied to emergency service with sudden dyspnea and bilateral chest pain

SYNCHRONOUS BILATERAL PRIMARY SPONTANEOUS PNEUMOTHORAX

PURPOSE: Synchronous Bilateral Primary Spontaneous Pneumothorax (SBPSP) is a rare but life threatening clinical situation in Thoracic Surgery Emergencies. SBPSP requires urgent intervention and treatment. Our aim is to find the rate of SBPSP and discuss the treatment modalities.

Bilateral Primary Spontaneous Pneumothorax

A case of bilateral primary spontaneous pneumothorax ("buffalo chest") in a previously healthy man is described. The clinical presentation and treatment options are discussed.

Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax

To review our experience of the treatment of bilateral primary spontaneous pneumothorax (PSP) by video-assisted thoracoscopic surgery (VATS). Retrospective chart review was followed by an on-clinic or telephone interview. Patients were cared for by one thoracic surgeon in four medical centers or community hospitals in Northern and Central Taiwan. Thirteen patients with bilateral PSP underwent bilateral VATS simultaneously or sequentially from July 1994 to December 2005. Twelve males and one female, with age ranging from 15 to 36 years (mean 23.1 years), were treated with VATS for bilateral PSP, under the indications of bilateral pneumothoracis simultaneously (n=4) or sequentially (n=9). The interval between the first and second contra-lateral VATS procedure for non-simultaneous PSP patients ranged from 7 d to 6 years. Eleven of 13 patients (84.6%) had prominent pulmonary bullae/blebs, and underwent bullae resection with mechanical or chemical pleurodesis. The mean operative time was (45.6+/-18.3) min (range 25 approximately 96 min) and (120.6+/-28.7) min (range 84 approximately 166 min) respectively for the non-simultaneous (second VATS for the recurrence of contralateral side after first VATS) and simultaneous (bilateral VATS in one operation) procedures. There was no postoperative mortality. However, prolonged air leakage (>7 d) occurred in one patient (7.7%) who recovered after conservative treatment. The mean duration of chest tube drainage was 3.1 d and the median follow up period was 3.4 years. VATS is a safe and effective procedure in the treatment of bilateral PSP. Bilateral VATS is only recommended for patients with simultaneously bilateral PSP, because the incidence of recurrence, even with visible bullae, was not so high in my group and in some previous literature. Bilateral VATS in a supine position should only be used in selective cases, because of possible pleural adhesion or hidden bullae on the posterior side.

Simultaneous bilateral primary spontaneous pneumothorax

While primary spontaneous pneumothorax (PSP) is common in adolescents and young adults, simultaneous bilateral PSP (SBPSP) is rare and can be life-threatening if it progresses to tension pneumothorax. This study reviewed cases of PSP to identify the clinical features of SBPSP. All patients with PSP diagnosed and treated between June 1996 and June 2006 were reviewed, and the clinicoradiological features and outcomes were evaluated. Of the 616 patients with 807 episodes of PSP, 13 had SBPSP (1.6%) at first presentation, and all were male (mean age 20.9 +/- 4.7 years, range 16-25 years). Compared with the non-SBPSP patients, SBPSP patients had significantly lower body weight and BMI (P = 0.018 and <0.001, respectively) and higher body height/body weight ratio (P = 0.004). There was no significant difference in their age, sex, smoking habits or body height. Patients with SBPSP had a significantly higher incidence of bleb/bullae seen in HRCT of the lung compared with non-SBPSP (88.5% vs 63.5%, P = 0.016). In multiple logistic regression analysis, BMI and presence of blebs/bullae were independent risk factors for SBPSP. All patients with SBPSP received bilateral video-assisted thoracoscopic surgery and recovered uneventfully. The mean follow-up period was 3.7 years (range 10 months-7 years). Patients with PSP having a lower BMI, and bilateral bleb/bullae formation are at higher risk for the development of SBPSP. SBPSP needs urgent assessment and management, and bilateral video-assisted thoracoscopic surgery is a safe and effective treatment.

Simultaneous bilateral spontaneous pneumothorax: a case report

lettersSimultaneous bilateral spontaneous pneumothorax: a case report Burcin Celik and Hale Kefeli Celik Burcin Celik Search for more papers by this author and Hale Kefeli Celik Search for more papers by this author Published Online:5 Apr 2007https://doi.org/10.5144/0256-4947.2007.130SectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionTo the Editor: Pneumothorax is the presence of air in the pleural space with secondary lung collapse. Simultaneous bilateral spontaneous pneumothorax (SBSP), defined as the concurrent occurence of pneumothorax in both hemithoraces is a rare clinical condition in the literature, mainly seen in patients with underlying lung disease.1 The incidence of spontaneous pneumothorax is 9 per 100 000 and 1.3 percent of these cases are bilateral and simultaneous.2 We describe a young patient with simultaneous bilateral spontaneous pneumothorax.A 23-year-old patient was admitted to our emergency service 1 hour after the sudden onset of dyspnea and chest pain. There was no history of trauma to the chest. He denied any history of smoking. Physical examination showed that the patient was a tall, thin man. He was tachycardic and normotensive. He was in apparent distress with a respiratory rate of 22 breaths/minute. The examination of the chest revealed that breath sounds were decreased bilaterally. The percussion note was resonant in all areas of the chest. The trachea was not displaced. Laboratory findings were normal.The chest radiograph confirmed total pneumothorax on the right side and partial pneumothorax on the left side (Figure 1). Simultaneous tube thoracostomy was carried out on both the right and left hemithorax. Both lungs were soon fully reexpanded. A computed tomography scan was normal. No underlying emphysematous change or bullous disease was identified. We decided to operate on the left side because the air leak was continuous. But the patient did not accept the operation. As the air leak stopped on the right side on the fifth day and on the left side on the seventh day, the thoracic tubes were removed. To prevent any recurrence, bilateral chemical pleurodesis with tetracycline was performed. The patient was discharged on day 9 and was asymptomatic at 5 months follow-up.Figure 1 Chest radiograph taken on the day of admission showing bilateral pneumothoraces with complete collapse of the right lung and partial collapse of the left lung.Download FigureSpontaneous pneumothorax is more frequent in young, tall and thin males, and more common in smokers. The most common cause of spontaneous pneumothorax is the rupture of small subpleural bleps. Simultaneous bilateral spontaneous pneumothorax is a rare clinical event. There are isolated reports of bilateral pneumothorax secondary to trauma, malignancy, high-pressure ventilation and catheterization.Most case reports in the literature were associated with malignancy.1,3 A few cases of simultaneous bilateral primary spontaneous pneumothorax have been reported in the literature, as in our case.The clinical presentation of SBSP can be variable. Patients have presented with clinical signs and symptoms ranging from cardiopulmonary failure to as little as mild dyspnea.4 Symptoms may be equal bilaterally. Spontaneous pneumothorax is generally diagnosed by the clinical features. The diagnosis should be based on radiological findings. The chest radiograph constitutes the basis of radiological examination. CT of the chest is indicated to detect underlying causes of spontaneous pneumothorax.3,4 Our patient presented with typical signs and symptoms of pneumothorax and the CT scan was normal.The treatment options for pneumothorax range from observation to thoracotomy. These treatment options include needle aspiration, percutaneous catheter drainage, tube thoracostomy with or without chemical pleurodesis, and video-assisted thoracic surgery. There are some controversies about the treatment of simultaneous bilateral spontaneous pneumothorax. Initially, chest drainage is essential in the treatment.3–5The main goals of pneumothorax treatment are to obtain complete lung expansion and to attempt recurrence prevention. We think that simultaneous bilateral primary spontaneous pneumothorax can be managed initially by chest tube drainage. Then one side of the hemithorax should be operated to reduce the risk of recurrence.ARTICLE REFERENCES:1. Sunam G, Gok M, Ceran S, et al. "Bilateral pneumothorax: a retrospective analysis of 40 patients" . Surg Today. 2004; 34:817-821. Google Scholar2. Melton LJ, Hepper NG, Offord KP. "Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974" . Am Rev Res Dis. 1979; 120:1379-1382. Google Scholar3. Graf-Deuel E, Knoblauch A. "Simultaneous bilateral spontaneous pneumothorax" . Chest. 1994; 105:1142-6. Google Scholar4. Sayar A, Turna A, Metin M, et al. "Simultaneous bilateral spontaneous pneumothorax report of 12 cases and review of the literature" . Acta Chir Belg. 2004; 104:572-6. Google Scholar5. Ayed AK. "Bilateral video-assisted thoracoscopic sugery for bilateral spontaneous pneumothorax" . Chest. 2002; 122:2234-7. Google Scholar Previous article Next article FiguresReferencesRelatedDetails Volume 27, Issue 2March-April 2007 Metrics History Published online5 April 2007 InformationCopyright © 2007, Annals of Saudi MedicineThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.PDF download

Primary spontaneous pneumothorax: one-stage treatment by bilateral videothoracoscopy

Background. The goal of the study was to report our 7-year experience with single-stage bilateral videothoracoscopy for bleb excision and pleural abrasion in patients suffering primary spontaneous pneumothorax. Methods. From November 1992 through June 1999, 12 men were operated on in our department. Preoperative chest computed tomographic scans were obtained for all patients. Operative indications included simultaneous bilateral pneumothorax (n = 2), contralateral recurrence (n = 1), ipsilateral recurrence with contralateral blebs or bullae, and job restrictions (n = 9). Results. Mean age at operation was 26 ± 6 years. All patients had multiple blebs or bullae located in upper lobes, and 4 patients (33%) had pleural adhesions. All blebs or bullae were resected at operation. The mean number of staple cartridges was 5 per patient (range, 3 to 8). All patients had bilateral pleurabrasion. There were no perioperative complications and no conversion to thoracotomy. The mean operative time was 168 ± 17 minutes (range, 140 to 190 minutes). The mean drainage time was 5 days (range, 4 to 26 days) and the mean hospital stay was 7.7 ± 1.4 days for 11 of 12 patients. Postoperative complications included prolonged air leak (16.5%), incomplete lung reexpansion (25%), and pleural effusion (8.5%). One patient required reoperation on the right side through transaxillary thoracotomy within 1 month of videothoracoscopy for pleurodesis failure. Follow-up was 100% complete. Mean follow-up is 50 ± 34 months (range, 9 to 88 months) and no patient has had recurrence of pneumothorax. All patients except one returned to full occupational activity within 5 weeks of surgery. Conclusions. Single-stage bilateral videothoracoscopy for bilateral bleb excision and pleurabrasion is a safe procedure that does not result in major complications and provides excellent long-term results. This approach could be considered in young patients with bilateral primary spontaneous pneumothorax, or in those requiring radical therapy for the prevention of ipsilateral and contralateral recurrences.