Outcome and Risk Factors of Recurrence After Thoracoscopic Bullectomy in Young Adults with Primary Spontaneous Pneumothorax

Overview

Journal Surg Today

Specialty General Surgery

Date 2016 Dec 3

PMID 27909813

Citations 17

Authors

Takashi Nakayama

Yusuke Takahashi

Hirofumi Uehara

Noriyuki Matsutani

Masafumi Kawamura

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate the risk factors of recurrence of pneumothorax following thoracoscopic bullectomy in young adults.

Methods: Between January, 2005 and September, 2015, 167 patients aged ≤40 years underwent initial thoracoscopic bullectomy for primary spontaneous pneumothorax (PSP) at our hospital. Recurrence-free probability was calculated from the date of surgery to recurrence or last follow-up, using the Kaplan-Meier method.

Results: Sixteen (9.6%) of the 167 patients suffered a recurrence (collective total, 16 recurrences). The recurrence-free intervals were 3-107 months (median 25.8 months), and the 5-year recurrence-free probability was 85.9%. Multivariate Cox analysis demonstrated that age ≤23 years (p = 0.029) and a history of ipsilateral pneumothorax before surgery (p = 0.029) were significantly associated with higher risk of recurrence. The 5-year recurrence-free probability was 72.3% for patients aged ≤23 years and a history of ipsilateral pneumothorax before surgery and 94.1% for those with neither of these factors (p = 0.001). Recurrence developed within 3 years after surgery in 14 of the 16 patients.

Conclusions: Patients ≤23 years of age with a history of ipsilateral pneumothorax before surgery are at significantly high risk of its recurrence, frequently within 3 years; thus, the risk of postoperative recurrence of a pneumothorax must be kept in mind.

Citing Articles

Post-surgery spontaneous pneumothorax: Long-term recurrence rates and follow-up challenges revealed by a written survey.

Nonomura R, Yabe R, Oshima Y, Sasaki T, Ishibashi N, Sugawara T PLoS One. 2024; 19(10):e0307910.

PMID: 39388419 PMC: 11466418. DOI: 10.1371/journal.pone.0307910.

Incidence and risk factors for recurrent primary spontaneous pneumothorax after video-assisted thoracoscopic surgery: a systematic review and meta-analysis.

Huang N, He S, Chen S, Zhang G, Ruan L, Huang J J Thorac Dis. 2024; 16(6):3696-3710.

PMID: 38983166 PMC: 11228730. DOI: 10.21037/jtd-24-175.

Population-based study on surgical care for primary spontaneous pneumothorax.

van Steenwijk Q, Spaans L, Heineman D, van den Broek F, Dickhoff C Eur J Cardiothorac Surg. 2024; 65(4).

PMID: 38489837 PMC: 10980590. DOI: 10.1093/ejcts/ezae104.

Non-stapling thoracoscopic surgery for spontaneous pneumothorax in young patients.

Suzuki H, Tsunezuka H, Okada S, Shimomura M, Ishihara S, Inoue M Gen Thorac Cardiovasc Surg. 2023; 72(6):395-400.

PMID: 38062327 DOI: 10.1007/s11748-023-01992-x.

Risk factors for the recurrence of primary spontaneous pneumothorax after video-assisted thoracoscopic surgery in patients younger than 40 years.

Shigenobu T, Ohtsuka T, Yoshizu A J Thorac Dis. 2023; 15(7):3783-3790.

PMID: 37559612 PMC: 10407527. DOI: 10.21037/jtd-23-257.

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