[Spontaneous pneumothorax; to operate or not?].

Disagreement remains on the best mode of therapy for spontaneous pneumothorax (SP). Treatment options vary from observation alone to thoracotomy depending on the stage of the disease and the preference of the physician. Between 1983 and 1988, 122 patients with SP were treated at the Elisabeth Hospital Tilburg according to a fixed protocol.

The femoro-femoral cross-over bypass.

From 1984 to 1990 64 patients (56 men and 8 women) with a mean age of 67.1 years (36-88 yrs.) were treated with a femoro-femoral cross-over bypass (45 primary and 19 secondary procedures).

Ascites after pleuroperitoneal shunting.

If conventional therapy fails in patients with intractable malignant pleural effusion, the pleuroperitoneal shunt is a valuable alternative. In a 59-year-old man with disabling malignant pleural effusion, massive ascites developed shortly after insertion of a pleuroperitoneal shunt. This shunt was replaced by a pleurovenous shunt.

PTFE versus human umbilical vein in above knee femoro-popliteal bypass. Early results of a randomized clinical trial.

The results of a prospective randomized clinical trial comparing PTFE and HUV grafts in above knee femoro-popliteal reconstruction are presented. A total of 93 limbs were randomized, three patients died in the early postoperative period, leaving 90 (45 PTFE and 45 HUV bypasses) to be analysed. During 18 months of follow-up only 3 HUV grafts occluded in contrast to 15 occluded PTFE grafts.

Intramedullary fixation of fracture of the sternum.

A case of fracture of the sternum in a patient suffering from osteogenesis imperfecta is presented. Internal fixation was carried out using a plate which was placed within the medulla. The described technique is simple and useful for the rarely indicated operative treatment of fractures of the sternum.

Semi-closed thromboendarterectomy of the femoro-popliteal artery (results of 142 consecutive cases, 5 years after operation).

Semi-closed thromboendarterectomy with the aid of a ring stripper appears not yet to have been abandoned as a method of reconstruction in occlusions in the femoro-popliteal tract. In a series of 142 operations, 5 years postoperatively, 44% of the stripped vascular tracts were still patent and 41% were occluded. Eighteen patients, in whom 20 operations had been performed, had died less than 5 years after the operation.