Dr. Nicolaidis has had 12 cases of pneumothorax in his first 1000 explants. Why did none of the patients require hospitalization or chest tube afterward?
There are different types and causes of pneumothorax.
A simple pneumothorax means that air has entered between the lung and the chest wall, which is not dangerous. This is what happened with Dr. Nicolaidis‘ 12 cases after a small hole developed in the pleura (plèvre in French) that surrounds the lungs, as the capsule was being peeled away from the rib cage.
The danger occurs if air continues to enter the space between the lung and the chest wall, causing the lung to collapse. This is called tension pneumothorax. In the case of an explantation, a tension pneumothorax would require damage to the lung as well as the pleura. Although a hole can develop in the pleura as the capsule is peeled away from the rib cage, Dr. Nicolaidis never comes close to the actual lungs. So it is almost impossible to develop a tension pneumothorax.
