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Contralateral Recurrence and Temporal Trend After First Side Surgery for Primary Spontaneous Pneumothorax: A
Antonio Giulio Napolitano1, Dania Nachira1, Gloria Santoro2
1Department of Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00136 Rome, Italy.
Journal of Personalized Medicine
|May 26, 2026
Summary
Contralateral recurrence after primary spontaneous pneumothorax surgery occurs in 12% of cases, with younger patients experiencing earlier recurrence. Seasonality may also influence recurrence patterns, warranting further investigation into preventive strategies.
Area of Science:
- Thoracic Surgery
- Pulmonology
- Epidemiology
Background:
- Contralateral recurrence after surgical treatment for primary spontaneous pneumothorax (PSP) is a significant clinical concern with limited understanding.
- This study addresses the need for a comprehensive evaluation of contralateral recurrence incidence and risk factors in a large, multicenter cohort.
Purpose of the Study:
- To determine the incidence of contralateral recurrence following surgical treatment for PSP.
- To assess the role of clinical factors in risk stratifying patients for contralateral recurrence.
- To analyze the time to contralateral recurrence and identify potential influencing factors.
Main Methods:
- Retrospective review of 479 patients surgically treated for PSP across three Italian centers (2012-2024).
- Exclusion of secondary pneumothorax, patients under 18, emphysema, large bullae, and thoracotomy approaches.
- Statistical analysis included chi-square tests, t-tests, and Kaplan-Meier survival curves to assess associations and time to recurrence.
Main Results:
- A 12% contralateral recurrence rate was observed in 59 patients.
- Younger age (<34 years) was associated with an increased risk (IRR 1.23) of contralateral recurrence.
- Peak incidence for both initial PSP treatment and contralateral recurrence occurred in October, November, and January.
Conclusions:
- The study identifies a 12% contralateral recurrence rate post-PSP surgery, emphasizing the clinical significance of this complication.
- Younger age is a key factor associated with earlier contralateral recurrence, suggesting a need for tailored management.
- Observed seasonal patterns in recurrence warrant further investigation into underlying mechanisms and the development of preventive strategies.
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01:27Pneumothorax-II
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
01:26Pneumothorax-I
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
01:08Pneumothorax II: Pathophysiology
Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...