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Long-term clinical outcomes after initial secondary pneumothorax surgery
Mi Hyoung Moon1, Kyung Soo Kim1, Seok Whan Moon1
1Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Journal of Thoracic Disease
|November 16, 2023
Summary
Secondary pneumothorax (SP) recurrence is higher in patients with lung disease other than chronic obstructive pulmonary disease (COPD). Non-COPD lung conditions are a significant risk factor for SP recurrence after surgery.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Clinical Research
Background:
- Secondary pneumothorax (SP) presents treatment challenges due to diverse lung diseases and surgical risks.
- Standardizing care and early surgical intervention for SP are complex.
- Understanding SP recurrence is crucial for effective patient management.
Purpose of the Study:
- To document the clinical course of SP following initial surgical treatment.
- To analyze the risk factors associated with SP recurrence.
- To identify predictors of postsurgical pneumothorax recurrence.
Main Methods:
- Retrospective review of 160 patients with SP.
- Analysis of clinical, imaging, and operative data from an institutional database.
- Cox proportional hazards (PH) analysis to determine recurrence risk factors.
Main Results:
- Overall recurrence rate was 18.75% over a mean follow-up of 58.7 months.
- Underlying lung pathology other than COPD was the strongest predictor of recurrence (HR=5.3, P<0.001).
- Some patients experienced multiple pneumothorax episodes before surgery, particularly those without COPD.
Conclusions:
- Non-COPD lung disease is a confirmed risk factor for postsurgical SP recurrence.
- Frequent pneumothorax episodes may occur, especially in the absence of COPD.
- Consideration of underlying lung pathology is essential for treatment planning in SP.
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