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Primary Spontaneous Pneumothorax—Outcomes of Different Treatment Modalities

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Abstract

The aim of this study is to compare the recurrence rates with different modalities used as first-line treatment for first-episode primary spontaneous pneumothorax, and investigated the risk factors for recurrence. We retrospectively reviewed consecutive patients under 60 years of age who were treated for a first episode of primary spontaneous pneumothorax between May 1996 and May 2016 at our hospital. The patients were divided into 6 groups according to the treatment received. A total of 667 patients with 890 episodes of primary spontaneous pneumothorax were included in the analysis. The median follow-up period was 64.5 months. The recurrence rate in the 6 groups was as follows: observation, 52.5% (21/40); chest tube drainage, 32.6% (84/258); aspiration, 100% (42/42); axillary thoracotomy, 8.8% (9/102); 2-port video-assisted thoracoscopic surgery (VATS), 6.0% (7/117); and 3-port VATS, 10.6% (11/108). The recurrence rate was higher in non-surgery groups than in surgery groups (147/340 vs 27/327, P < 0.01). Pneumothorax size (odds ratio [OR] = 0.252, P = 0.017) and duration of chest tube drainage (OR = 0.687, P = 0.001) were independent risk factors for ipsilateral recurrence. In the management of first-episode primary spontaneous pneumothorax, the recurrence rate was higher in patients who were treated with conservative procedures as compared with surgery. Pneumothorax size and duration of chest tube drainage were risk factors for recurrence after initial treatment.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Second Affiliated Hospital of Kunming Medical University, No. 374th, Dianmian Road, Kunming, 650101, Yunnan Province, China

    Weijiang Ma, Feng Ling, Limin Yang, Shaojun Yang, Xu Li, Jianqiang Ma & Jia Liu

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  1. Weijiang Ma
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  2. Feng Ling
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  3. Limin Yang
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  4. Shaojun Yang
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  5. Xu Li
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Contributions

Weijiang Ma: Study design, project writing, and management, actually performing the study, viz., experiments, practical work, operative work, data acquisition, data analysis, statistical inferences, manuscript writing, and repeated editing and reviewing of the manuscript, Feng Ling: Conceptualization, study design, project writing and management, defining the study, extensive literature search, actually performing the study, viz., experiments, operative work, data acquisition, data analysis, statistical inferences, manuscript writing, and repeated editing and reviewing of the manuscript, Limin Yang: Conceptualization, study design, extensive literature search, data analysis, manuscript writing, and repeated editing and reviewing of the manuscript, Shaojun Yang: Conceptualization, study design, extensive literature search, experiments, data acquisition, data analysis, statistical inferences, Xu Li: Study design, project writing and management, defining the study, actually performing the study, Jianqiang Ma: Data acquisition, data analysis, statistical inferences, Jia Liu: Experiments, data acquisition

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Correspondence to Feng Ling.

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All authors contributed substantially to this study. The institution from where the article comes is a guarantor of the content. The study was approved by the Institutional Review Board of the Second Affiliated Hospital of Kunming Medical University.

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The authors declared no conflicts of interest concerning the authorship and /or publication of this article.

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Ma, W., Ling, F., Yang, L. et al. Primary Spontaneous Pneumothorax—Outcomes of Different Treatment Modalities. Indian J Surg 83, 645–651 (2021). https://doi.org/10.1007/s12262-020-02408-3

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  • DOI: https://doi.org/10.1007/s12262-020-02408-3

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