Risk Factors for the Recurrence of Primary Spontaneous Pneumothorax After Video-assisted Thoracoscopic Surgery in Patients Younger Than 40 Years

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2023 Aug 10

PMID 37559612

Authors

Takao Shigenobu

Takashi Ohtsuka

Akira Yoshizu

Affiliations

Soon will be listed here.

Abstract

Background: Video-assisted thoracoscopic surgery (VATS) is a standard primary spontaneous pneumothorax (PSP) procedure. However, its high recurrence rate compared to open thoracotomy is a problem. Therefore, various methods to prevent recurrence have been developed. The present study investigated the risk factors for postoperative recurrence of PSP after VATS.

Methods: From January 2008 to November 2022, 207 patients younger than 40 years of age without underlying pulmonary disease underwent thoracoscopic bullectomy for PSP. Among them, 96 underwent staple line reinforcement with a polyglycolic acid (PGA) sheet and autologous blood spraying. Patient characteristics and surgical outcomes were analyzed to determine the prognostic factors for postoperative recurrence.

Results: Twenty-seven patients (13.0%) experienced recurrences. A multivariate analysis using Cox regression analysis revealed that age younger than 20 years [P=0.039; hazard ratio (HR) =2.337; 95% confidence interval (CI): 3.283-17.287], history of contralateral pneumothorax (P<0.001; HR =7.533; 95% CI, 1.486-12.336), and no staple line reinforcement (P=0.007; HR =4.282; 95% CI, 1.043-5.236) were risk factors for recurrence after pneumothorax surgery.

Conclusions: Age younger than 20 years and history of contralateral pneumothorax were risk factors for postoperative recurrence of pneumothorax. Staple line reinforcement with a PGA sheet and spraying of autologous blood reduced the postoperative recurrence rate of PSP.

Citing Articles

Comparative clinical efficacy of single-incision thoracoscopic bullectomy combined with C-shaped electrocautery pleurodesis vs. chemical pleurodesis in the management of spontaneous pneumothorax.

Zhong B, Wu Q, Zhang M Front Surg. 2024; 11:1480240.

PMID: 39600536 PMC: 11588690. DOI: 10.3389/fsurg.2024.1480240.

Evaluation of the nonstapling bullectomy by manual suturing for young men with primary spontaneous pneumothorax.

Suzuki K, Kitami A, Komiyama S, Okada M, Takamiya S, Ohashi S J Thorac Dis. 2024; 16(9):5826-5834.

PMID: 39444917 PMC: 11494564. DOI: 10.21037/jtd-24-693.

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.

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