Hecker W C, Achatz M
Chirurg. 1985 May;56(5):319-21.
Basing on the fact that postoperative pneumothorax occurred in a third of 47 patients with diaphragmatic hernias and defects, the mechanisms of progressive respiratory insufficiency and the occurrence of postoperative pneumothorax are debated as well as therapeutical measures for prevention. It is suggested as an important therapeutical principle in order to prevent any negative pressure on the operated thoracic side and to keep by all means the mediastinum in the middle. By the aid of these therapeutical principles, an improvement of the still high lethality of 40% - which postoperative pneumothorax is decisive for - can be achieved.