Abstract
Background: Video-assisted thoracoscopic surgery (VATS) with bullectomy and partial pleurectomy (VBPP) is an increasingly used and well-established surgical treatment for primary spontaneous pneumothorax (PSP). However, reports on its effectiveness and long-term outcomes are limited. The aim of this study was to assess and compare long-term recurrence rates following VBPP and chest tube (CT) treatment and to identify potential risk factors for disease recurrence in patients with PSP. Methods: A total of 116 patients treated either by VBPP or CT were included in this study. Long-term recurrence rates and associations between clinical parameters and recurrence of pneumothorax were analyzed. Results: Sixty-two patients (53.4%) underwent VBPP, whereas 54 (46.6%) patients underwent CT treatment only. During a median follow-up period of 76.5 months, VBPP patients experienced a significantly lower recurrence rate compared to CT patients (6/62 vs. 35/54; p < 0.0001). CT treatment (VBPP vs. CT; p < 0.001) and a large initial pneumothorax size (Collins < 4 vs. Collins ≥ 4; p = 0.018) were independent risk factors for pneumothorax recurrence. Conclusion: VBPP is an effective and safe surgical treatment for PSP. Therefore, patients with a large pneumothorax size might benefit from VBPP, as they are at high risk for disease recurrence.
Highlights
We retrospectively reviewed data of 120 patients with primary spontaneous pneumothorax (PSP) treated either by Video-assisted thoracoscopic surgery (VATS) bullectomy with partial pleurectomy (VBPP) or by chest tube (CT) only between January 2008 and December 2020 in our institution
The mean pneumothorax sizes estimated according to Collins method were 13.4 cm and 13.9 cm in the VBPP and CT groups, respectively, indicating a large pneumothorax size for both patient cohorts
VBPP has been reported with superior performance and low rates of recurrence compared to VATS bullectomy alone [20,21,24,25]
Summary
The incidence of PSP has been reported with approximately 1–9.8 and 7–24 cases per 100,000 individuals per year in females and males, respectively [2,3]. Despite unknown etiology of PSP, associated risk factors for its occurrence and recurrence, such as male sex, tall stature, nicotine abuse, size of pneumothorax, and a family history of pneumothorax, have been reported [6,7,8,9]. Video-assisted thoracoscopic surgery (VATS) with bullectomy and partial pleurectomy (VBPP) is an increasingly used and well-established surgical treatment for primary spontaneous pneumothorax (PSP). The aim of this study was to assess and compare long-term recurrence rates following. VBPP and chest tube (CT) treatment and to identify potential risk factors for disease recurrence in patients with PSP. Long-term recurrence rates and associations between clinical parameters and recurrence of pneumothorax were analyzed.
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