Neo-generation of Neogenetic Bullae After Surgery for Spontaneous Pneumothorax in Young Adults: a Prospective Study

Overview

Journal J Cardiothorac Surg

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2019 Jan 25

PMID 30674336

Citations 16

Authors

Takuya Onuki

Tomoyuki Kawamura

Shuntaro Kawabata

Masatoshi Yamaoka

Masaharu Inagaki

Affiliations

Soon will be listed here.

Abstract

Background: To investigate the development of neogenetic bullae or blebs on 1-year postoperative chest computed tomography after video-assisted thoracic surgery (VATS) in young patients with primary spontaneous pneumothorax (PSP).

Methods: In this prospective study, 10- to 20-year-old patients with PSP were treated via VATS with additional procedures (bullectomy, cold coagulation, coverage, pleural abrasion, or chemical pleurodesis). All patients underwent the additional procedures and computed tomography of the chest 1 year postoperatively for the assessment of neogenetic bullae. Postoperative PSP recurrence was monitored, and recurrence-free survival was evaluated using Kaplan-Meier analysis.

Results: Fifty-seven patients (66 cases) aged 17 ± 2 years underwent VATS for PSP and were followed up for 938 ± 496 days. Of the 36 cases at 1-year follow-up, 23 (63.9%) showed neogenetic bullae, which were adjacent to the staple lines in 16 cases (69.6%). The 1- and 2-year recurrence-free survival rates were 88.9 and 85.1%, respectively. Nine of the 66 cases (13.6%) showed recurrence after 869 ± 542 days. A history of contralateral PSP was significantly associated with recurrence.

Conclusions: VATS, combined with additional procedures, provides acceptable long-term results in young patients with PSP. Additional procedures reduce the recurrence rate of PSP but do not prevent the occurrence of neogenetic bullae. A history of contralateral PSP is a potential risk factor for post-VATS recurrence in young patients.

Citing Articles

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CT features associated with contralateral recurrence of spontaneous pneumothorax.

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Prospective Observation Study for Primary Spontaneous Pneumothorax: Incidence of and Risk Factors for Postoperative Neogenesis of Bullae.

Furuta C, Yano M, Kitagawa Y, Katsuya R, Ozeki N, Fukui T Ann Thorac Cardiovasc Surg. 2024; 30(1).

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