Methods: Between January 2004 and December 2012, 22 patients with bullous lung disease complicated with spontaneous pneumothorax were included. The patients were divided into two groups. Ten patients in group 1 had heterogeneous emphysematous disease and the 12 patients in group 2 had homogenous emphysematous disease. Both groups underwent muscle-saving thoracotomy. Wedge resection was performed by using stapler. The resection line was supported with an expandable PTFE graft in six patients in group 1 and in five patients in group 2. Treatment results and complications were compared between the groups.

Results: Subtype of emphysema was the most important criterion which determined the result of the treatment. Although the use of PTFE graft support had no effect on complications in both emphysema subtypes, it shortened the duration of the chest tube withdrawal and the length of hospital stay.

Conclusion: We concluded that the most important criterion which determined the treatment outcome was subtype of emphysema and this led to reduced intubation time and length of hospital stay, although use of PTFE support in both emphysema types had no effect on complications.