Results of repeated video-assisted thoracic surgery for recurrent pneumothorax after primary spontaneous pneumothorax

Cho, Sukki; Jheon, Sanghoon; Kim, Dong Kwan; Kim, Hyeong Ryul; Huh, Dong Myung; Lee, Sung-Soo; Ryu, Kyoung Min; Cho, Deog Gon

doi:10.1093/ejcts/ezx409

Cited by 20 publications

(15 citation statements)

References 12 publications

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“…Recently, numerous etiologies of recurrent pneumothorax following VATS have been proposed. While missed bullae have been recognized as the reason for recurrent pneumothorax following VATS, new bullae formation is now being considered an important etiology (4)(5)(6)(7). We have previously reported that higher tension in the staple line which was associated with bulky resection during VATS, increased the risk of recurrence (7).…”

Section: Original Articlementioning

confidence: 99%

New bullae formation in the staple line increases the risk of recurrent pneumothorax following video-assisted thoracoscopic surgery bullectomy for primary spontaneous pneumothorax

Choi¹,

Kim²,

Suh³

et al. 2018

J. Thorac. Dis.

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Section: Original Articlementioning

confidence: 99%

New bullae formation in the staple line increases the risk of recurrent pneumothorax following video-assisted thoracoscopic surgery bullectomy for primary spontaneous pneumothorax

Choi¹,

Kim²,

Suh³

et al. 2018

J. Thorac. Dis.

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“…Muramatsu et al reported that the new bulla formation was the most common recurrence factor after VATS bullectomy alone for PSP (8). Cho et al observed that the most common reason for recurrent PSP after VATS was the formation of a bulla on the previous staple line, followed by a new bulla formation in a location other than the staple line (9). In our previous study, younger patients aged <25 exhibited a higher tendency for detection of postoperative bulla neogenesis on the staple line using HRCT, significantly (10).…”

Section: Discussionmentioning

confidence: 60%

“…However, it has recently been suggested that younger patients have a higher postoperative recurrence (21.9-27.9%) of pneumothorax than older patients, even if the same procedures for prevention of the postoperative Original Article Contralateral bulla neogenesis associated with postoperative recurrences of primary spontaneous pneumothorax in young patients recurrence are performed (4-7). Bulla neogenesis is thought to be the main reason for postoperative recurrence (8)(9)(10). In addition, it was reported that young patients aged <20 years frequently developed bulla neogenesis regardless of surgical treatment (11).…”

Section: Introductionmentioning

confidence: 99%

Contralateral bulla neogenesis associated with postoperative recurrences of primary spontaneous pneumothorax in young patients

Tsuboshima¹,

Matoba²,

Wakahara³

2019

J Thorac Dis

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Background: Video-assisted thoracoscopic surgery (VATS) is considered an acceptable treatment for recurrent primary spontaneous pneumothorax (PSP). However, recent reports have described a high postoperative recurrence rate in young patients with PSP. We hypothesized that ineffective VATS may have been performed for these patients (aged <25 years). We evaluated the factors preventing postoperative recurrence in young PSP patients in order to identify patients with effective surgery. Methods: Between April 2009 and December 2018, we retrospectively evaluated 92 patients aged <25 years who underwent first VATS bullectomy for PSP. Factors such as gender, smoking habit, history of contralateral PSP, family history, body mass index (BMI), and contralateral bulla neogenesis on highresolution computed tomography were evaluated. Results: The mean BMI was 18.8±1.8. Contralateral bulla neogenesis was present in 31 patients (33.7%).The median period of observation for postoperative recurrence was 401.5 days. Thirty cases (32.6%) developed postoperative recurrence. Univariate and multivariable analyses showed that a BMI ≥18.0 and no contralateral bulla neogenesis were significant factors preventing postoperative recurrence (P=0.018, hazard ratio: 0.41 and P=0.0046, hazard ratio: 0.25, respectively).Conclusions: Although the patients aged <25 years have a high rate of postoperative recurrence, the patients with BMI ≥18.0 and no contralateral bulla neogenesis have a significantly lower rate of postoperative recurrence rate.

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“…However, based on a study on chest computed tomography images acquired 1 year after surgery, Onuki et al reported that although the PGA covering reduced the SP recurrence rate, it did not prevent neogenetic bullae occurrence 31 . In a study comparing absorbable mesh covering with mechanical pleurodesis, Cho et al reported no difference in the frequency of new bullae; however, the PGA covering group exhibited a slightly reduced frequency of bullae occurrence at the staple line compared with mechanical pleurodesis 34 . Ten studies included in the present meta-analysis discussed the cause of recurrence 12,13,15,17,18,23,24,30,31 ; of these, seven concluded that the area along the staple line was not a cause of postoperative recurrence 12,13,15,18,24,30,31 .…”

Section: Discussionmentioning

confidence: 99%

Polyglycolic acid sheet covering to prevent recurrence after surgery for spontaneous pneumothorax: a meta-analysis

Kadomatsu

Fukui

Mori

et al. 2021

Sci Rep

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The coverage technique using absorbable mesh was first described in a European guideline published in 2015 as a preventive method for the recurrence of spontaneous pneumothorax. We performed a meta-analysis based on a literature search of primary studies that compared the postoperative recurrence rate of primary spontaneous pneumothorax between the use and nonuse of polyglycolic acid sheet coverage. Two reviewers independently selected and evaluated the quality of the relevant studies. The risk ratio in each study was calculated in a random-effect meta-analysis. Statistical heterogeneity among the included studies was quantitatively evaluated using the I2 index, and publication bias was assessed using a funnel plot. A total of 19 retrospective cohort studies were analyzed: 1524 patients who underwent wedge resection alone (the control group) and 1579 who received additional sheet coverage. Polyglycolic acid sheet coverage was associated with a lower recurrence rate than that in the control group (risk ratio: 0.27, 95% confidence interval 0.20–0.37, P < 0.001; I2 0%). The funnel plot suggested possible publication bias. The covering technique reduced the recurrence rate of pneumothorax after thoracoscopic surgery to one-fourth.

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Results of repeated video-assisted thoracic surgery for recurrent pneumothorax after primary spontaneous pneumothorax

Abstract: Repeated VATS was a feasible method to treat recurrent PSP after VATS for PSP.

Cited by 20 publications

References 12 publications

New bullae formation in the staple line increases the risk of recurrent pneumothorax following video-assisted thoracoscopic surgery bullectomy for primary spontaneous pneumothorax

New bullae formation in the staple line increases the risk of recurrent pneumothorax following video-assisted thoracoscopic surgery bullectomy for primary spontaneous pneumothorax

Contralateral bulla neogenesis associated with postoperative recurrences of primary spontaneous pneumothorax in young patients

Polyglycolic acid sheet covering to prevent recurrence after surgery for spontaneous pneumothorax: a meta-analysis

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