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Outcome and risk factors of recurrence after thoracoscopic bullectomy in young adults with primary spontaneous pneumothorax

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Abstract

Purpose

To investigate the risk factors of recurrence of pneumothorax following thoracoscopic bullectomy in young adults.

Methods

Between January, 2005 and September, 2015, 167 patients aged ≤40 years underwent initial thoracoscopic bullectomy for primary spontaneous pneumothorax (PSP) at our hospital. Recurrence-free probability was calculated from the date of surgery to recurrence or last follow-up, using the Kaplan–Meier method.

Results

Sixteen (9.6%) of the 167 patients suffered a recurrence (collective total, 16 recurrences). The recurrence-free intervals were 3–107 months (median 25.8 months), and the 5-year recurrence-free probability was 85.9%. Multivariate Cox analysis demonstrated that age ≤23 years (p = 0.029) and a history of ipsilateral pneumothorax before surgery (p = 0.029) were significantly associated with higher risk of recurrence. The 5-year recurrence-free probability was 72.3% for patients aged ≤23 years and a history of ipsilateral pneumothorax before surgery and 94.1% for those with neither of these factors (p = 0.001). Recurrence developed within 3 years after surgery in 14 of the 16 patients.

Conclusions

Patients ≤23 years of age with a history of ipsilateral pneumothorax before surgery are at significantly high risk of its recurrence, frequently within 3 years; thus, the risk of postoperative recurrence of a pneumothorax must be kept in mind.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan

    Takashi Nakayama, Yusuke Takahashi, Hirofumi Uehara, Noriyuki Matsutani & Masafumi Kawamura

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  1. Takashi Nakayama
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  2. Yusuke Takahashi
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  3. Hirofumi Uehara
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  4. Noriyuki Matsutani
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  5. Masafumi Kawamura
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Correspondence to Takashi Nakayama.

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Nakayama, T., Takahashi, Y., Uehara, H. et al. Outcome and risk factors of recurrence after thoracoscopic bullectomy in young adults with primary spontaneous pneumothorax. Surg Today 47, 859–864 (2017). https://doi.org/10.1007/s00595-016-1452-z

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  • DOI: https://doi.org/10.1007/s00595-016-1452-z

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