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Risk factors for recurrence of primary spontaneous pneumothorax after thoracoscopic surgery
Hisatoshi Asano1, Takashi Ohtsuka1, Yuki Noda1
1Division of Thoracic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Background:
Recurrence of pneumothorax after thoracoscopic surgery is a concerning issue for thoracic surgeons. In this study, we aimed to determine the risk factors for recurrence of spontaneous pneumothorax after thoracoscopic surgery.
Methods:
A total of 192 patients with spontaneous pneumothorax aged <50 years who underwent thoracoscopic surgery from January 2010 to December 2016 were included in this study. Pre- and post-operative characteristics were obtained from medical records, and recurrent and non-recurrent cases were compared.
Results:
Fourteen patients (7.3%) experienced pneumothorax recurrence. Pneumothorax recurrence was observed more frequently in patients aged <20 years (P=0.041) and those in whom bullae were not identified on preoperative computed tomography (CT) (P=0.049). The use of polyglycolic acid (PGA) sheets during surgery significantly decreased the recurrence rate (P=0.031). A history of ipsilateral pneumothorax before surgery was a significant risk factor for recurrence after thoracoscopic surgery (P=0.001). In the multivariate analysis, a history of ipsilateral pneumothorax and identification of bullae on CT were identified as significant risk factors for recurrence.
Conclusions:
A history of ipsilateral pneumothorax, and inability to identify bullae on preoperative CT were risk factors for postoperative recurrence of pneumothorax.
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