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Long-term ipsilateral recurrence and contralateral risk following surgery for primary spontaneous pneumothorax in

Daichi Ishii1,2, Nozomi Hatanaka3, Miho Aoyagi1

  • 1Department of Thoracic Surgery, Sapporo City General Hospital, Sapporo, Japan.

Journal of Thoracic Disease
|April 16, 2026
PubMed

Insights

Younger patients (≤19 years) with primary spontaneous pneumothorax (PSP) have higher recurrence rates after surgery. Prolonged follow-up, at least 3 years, is recommended for this age group to monitor for recurrence and new pneumothorax events.

Area of Science:

  • Thoracic surgery
  • Pulmonology
  • Pediatric surgery

Background:

  • Primary spontaneous pneumothorax (PSP) is prevalent in young individuals.
  • Optimal follow-up duration and age-specific recurrence risks post-surgery for PSP are not well-defined.

Purpose of the Study:

  • To evaluate long-term surgical outcomes for PSP in patients aged ≤19 years compared to those aged 20-29 years.
  • To assess recurrence rates and postoperative imaging findings based on age groups.

Main Methods:

  • Retrospective analysis of 357 patients (aged 10-29 years) who underwent thoracoscopic bullectomy with pleural covering.
  • Patients were categorized into ≤19 years (further divided into ≤15 and 16-19 years) and 20-29 years age groups.
  • Comparison of clinical data, recurrence rates, and CT findings; recurrence-free survival analyzed using Kaplan-Meier method.

Main Results:

  • Patients aged ≤19 years exhibited higher crude rates of ipsilateral recurrence (12.3%) and contralateral pneumothorax (18.1%) compared to the 20-29 year group.
  • The ≤15-year subgroup showed the highest crude recurrence rates.
  • Postoperative CT scans revealed new bullae in both age groups, with contralateral events observed even after 5 years.

Conclusions:

  • Younger PSP patients, especially those ≤15 years, demonstrate a higher tendency for postoperative recurrence and contralateral pneumothorax.
  • Age-specific follow-up strategies for a minimum of 3 years are recommended despite non-significant differences in recurrence-free survival on Kaplan-Meier analysis.
Abstract

Keywords:
Primary spontaneous pneumothorax (PSP)long-term follow-uppleural coveringpostoperative recurrenceteenage patients

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