Germonpre Peter, Van Renterghem Elke, Dechamps Nicolas, Onghena Thierry, Van Aken Joke
Centre for Hyperbaric Oxygen Therapy, Military Hospital Brussels, 1120, Brussels, Belgium.
Emergency Department, St Lucas Hospital, Ghent, Belgium.
J Cardiothorac Surg. 2020 Jul 28;15(1):191. doi: 10.1186/s13019-020-01233-9.
Primary Spontaneous Pneumothorax (PSP) is considered an absolute and definitive contraindication for scuba diving and professional flying, unless bilateral surgical pleurectomy is performed. Only then is there a sufficiently low risk of recurrence to allow a waiver for flying and/or diving.
A young fit male patient who suffered a PSP 6 years ago, and underwent an uncomplicated videoscopic surgical pleurectomy, presented with a complete collapse of the lung on the initial PSP side. Microscopic examination of biopsies showed a slightly inflamed tissue but otherwise normal mesothelial cells, compatible with newly formed pleura.
Even with pleurectomy, in this patient, residual mesothelial cells seem to have had the capacity to create a completely new pleura and pleural space. The most appropriate surgical technique for prevention of PSP may still be debated.
原发性自发性气胸（PSP）被认为是水肺潜水和职业飞行的绝对明确禁忌证，除非进行双侧手术胸膜切除术。只有在那时，复发风险才足够低，从而允许豁免飞行和/或潜水。
一名6年前患PSP且接受了无并发症的电视胸腔镜手术胸膜切除术的年轻健康男性患者，其最初发生PSP一侧的肺完全萎陷。活检的显微镜检查显示组织有轻度炎症，但间皮细胞正常，与新形成的胸膜相符。
即使进行了胸膜切除术，在该患者中，残留的间皮细胞似乎仍有能力形成全新的胸膜和胸膜腔。预防PSP最合适的手术技术可能仍存在争议。
