Risk factors for recurrence of primary spontaneous pneumothorax after thoracoscopic surgery

Huang, Haibo; Hua, Jinping; Tian, Hui

doi:10.5582/bst.2015.01070

Cited by 17 publications

(16 citation statements)

References 17 publications

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“…Recurrence of PSP is more common at a younger age, because imbalanced development of the lungs and body cannot be corrected by surgery (20). According to the American College of Chest Physicians (21) and BTS guidelines (4), the preferred approach for prevention of recurrent pneumothorax is still surgical because of lower recurrence rates compared with instillation of sclerosing agents through a chest tube.…”

Section: Discussionmentioning

confidence: 99%

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

Chen¹,

Huang²,

Chang³

et al. 2016

J. Thorac. Dis.

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IntroductionPrimary spontaneous pneumothorax (PSP) usually occurs in young, tall, and lean men, especially smokers with no obvious underlying lung disease. It arguably results from rupture of subpleural blebs or bullae. The most frequent complication of PSP is recurrence, which is estimated to occur in 20% to 60% after conservative treatment (1,2). More than 50% of patients with PSP have contralateral blebs/bullae and about a quarter will develop contralateral pneumothorax (3). The British Thoracic Society (BTS) guidelines include first recurrence of contralateral pneumothorax and synchronous bilateral PSP as the only indications for surgery of the contralateral lung (4). However, surgery of the contralateral lung to prevent possible complications remains controversial (5-7). To date, only few studies on small populations have discussed both ipsilateral and contralateral recurrences of PSP. The purpose of our study was to identify the predictors of ipsilateral and contralateral recurrences of PSP and to review literatures on the association of blebs/bullae on high resolution computed tomography (HRCT) of the chest with PSP recurrence. Knowing the risk factors for PSP recurrence may enable us to optimize patient selection to avoid further recurrence and complications.

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Section: Discussionmentioning

confidence: 99%

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

Chen¹,

Huang²,

Chang³

et al. 2016

J. Thorac. Dis.

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“…Among 10 recent retrospective studies, including >2,000 pediatric and adult patients, recurrence after VATS averaged 13% (range, 7%-21%), suggesting a significant reduction compared with non-surgically treated patients (Table 4). 8,11,103,104,110,[113][114][115][116][117] Among studies reporting the laterality of post-VATS recurrences, 54% were contralateral to the site of surgery (Table 4). 8,11,113,114 Younger age at the time of VATS was a consistent risk factor for post-VATS recurrence among studies performing multivariate analyses.…”

Section: Prevention Of Recurrence: Vats and Pleurodesismentioning

confidence: 99%

“…8,11,113,114 Younger age at the time of VATS was a consistent risk factor for post-VATS recurrence among studies performing multivariate analyses. 104,110,113,116,117 The high rate of contralateral recurrences in younger patients suggests that the underlying pathogenesis leading to a pneumothorax may progress independent of surgical interventions in developing lungs.…”

Section: Prevention Of Recurrence: Vats and Pleurodesismentioning

confidence: 99%

“…Retrospective studies show lower recurrence rates post-VATS in patients undergoing mechanical and chemical pleurodesis. 112,113,116 However, an RCT of adolescents and adults with PSP found no difference in 18-month recurrence rates between thoracoscopic wedge resection with or without pleural abrasion. 119 RCTs comparing mechanical pleural abrasion with either apical pleurectomy, chemical pleurodesis with minocycline, or staple line coverage with cellulose mesh and fibrin glue have not demonstrated any approach to be more effective in preventing recurrences.…”

Section: Prevention Of Recurrence: Vats and Pleurodesismentioning

confidence: 99%

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An evidence‐based review of primary spontaneous pneumothorax in the adolescent population

Wilson

Rymeski

et al. 2021

JACEP Open

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Primary spontaneous pneumothorax (PSP) is a relatively common problem in emergency medicine. The incidence of PSP peaks in adolescence and is most common in tall, thin males. Recent advances in the care of patients with PSP have called into question traditional approaches to management. This clinical review highlights the changing management strategies for PSP and concludes with a proposed evidence-based pathway to guide the care of adolescents with PSP.

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“…In addition, we may avoid surgical treatment for pneumothorax, because a young age is considered a risk factor for recurrence after VATS procedures for spontaneous pneumothorax (12). Avoiding VATS may in turn have resulted in underestimation of the prevalence of TE in younger patients.…”

Section: Discussionmentioning

confidence: 99%

Two Young Women with Left-sided Pneumothorax Due to Thoracic Endometriosis

et al. 2016

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Pneumothorax associated with thoracic endometriosis (TE) generally occurs in women around 30 years old and it usually affects the right pleural cavity. We herein report two cases of TE associated with left-sided pneumothorax in young women. The prevalence of TE in younger patients may be underestimated if these cases are treated as spontaneous pneumothorax. Pneumothorax occurring in younger patients has not been reported to show laterality. TE-related or catamenial pneumothorax in young women must therefore represent a different clinical entity from the condition seen in older patients.

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Risk factors for recurrence of primary spontaneous pneumothorax after thoracoscopic surgery

Cited by 17 publications

References 17 publications

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

An evidence‐based review of primary spontaneous pneumothorax in the adolescent population

Two Young Women with Left-sided Pneumothorax Due to Thoracic Endometriosis

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