Prolonged air leak after video-assisted thoracoscopic surgery in patients with primary spontaneous pneumothorax

Patients who have undergone a lung resection owing to primary spontaneous pneumothorax (PSP) may develop prolonged air leak (PAL) during the postoperative period. The present study investigates potential risk factors associated with postoperative PAL in patients who were operated on for PSP.

Patients who underwent operations for PSP between January 2004 and November 2017 were investigated retrospectively. Patients who developed postoperative PAL constituted Group 1, and patients without PAL formed Group 2. A comparison of the two groups was made to identify potential risk factors for the development of prolonged air leak.

Of the total 79 patients who underwent operations, 18 (22.78%) developed prolonged air leak. All of the patients in Group 1 were male, and the mean age of this group was 23.72 ± 5.76 (18-36) years. Of the patients in Group 2, 51 (83.61%) were male and 10 (16.39%) were female, and the mean age of this group was 25.81 ± 5.91 (17-39) years. There was no statistically significant difference noted between the two groups regarding the investigated factors including age, gender, the total number of previous episodes, number of ipsilateral episodes, number of contralateral episodes, the preferred treatment method for the last episode, smoking status, computerized tomography findings, or the presence of a preoperative air leak.

PAL is the most common complication associated with PSP surgeries. Although several factors may affect PAL development, no definite conclusion could be drawn concerning the investigated risk factors. We believe that similar studies may contribute to the care of this rare patient population.