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Published on: May 26, 2023
[Early complications after surgical treatment of spontaneous pneumothorax: risk factors analysis]
G M Agafonov1, A S Petrov1,2, O V Novikova1,2
1Saint-Petersburg State University, Saint-Petersburg, Russia.
Objective:
To study the risk factors of complications after wedge resection with subsequent pleurectomy.
Material And Methods:
There were 454 patients diagnosed with spontaneous pneumothorax between 2018 and 2023. Surgical intervention was performed in 331 (72.9%) patients according to commonly accepted indications for prevention of recurrence. Risk factors were studied using regression analysis and directed acyclic graph (DAG) method to build predictive models.
Results:
The complication rate was 11.5% (n=38). The most common complications were intrapleural bleeding and prolonged air leak (3.9% and 3.6%, respectively). One-third of cases were classified as major complications according to the Clavien-Dindo classification in thoracic surgery and required pleural cavity drainage or debridement. Significant risk factors of postoperative complications were secondary pneumothorax (HR 4.009; 95% 1.147-14.013; p=0.030) and severe pleural adhesions (HR 4.258; 95% 1.134-15.991; p=0.032).
Conclusion:
Secondary pneumothorax and severe pleural adhesions are independent risk factors of postoperative complications.
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