Department University Hospital General Thoracic Surgery, Clinical Departments Position
|Article types||journal article|
|Peer review||Peer reviewed|
|Title||What is the best treatment strategy for primary spontaneous pneumothorax?
A retrospective study
|Journal||Formal name：Annals of Medicine and Surgery|
|Domestic / Foregin||Foregin|
|Volume, Issue, Page||45(*),98-101頁|
|Author and coauthor||Yasuhiro Chikaishia, Masatoshi Kanayama, Akihiro Taira, Yusuke Nabe, Shinji Shinohara,
Taiji Kuwata, Ayako Hirai, Naoko Imanishi, Yoshinobu Ichiki, Fumihiro Tanaka
|Summary||Background: Several treatment strategies are available for primary spontaneous pneumothorax (PSP). Surgical
procedures are also performed in patients with PSP without an absolute indication for surgery. This study was
performed to investigate the best treatment strategy for PSP by comparison of the recurrence rate.
Materials and methods: From January 2006 to December 2013, 149 patients with PSP aged ≤50 years were
treated in our institution. We reviewed the recurrence rate of PSP for each treatment strategy and evaluated the
association between the recurrence rate of PSP with the clinicopathological characteristics. We also compared
the surgery and non-surgery groups.
Results: A significant difference in the PSP recurrence rate was found between the surgery and non-surgery
groups (22% vs. 52%, respectively; p < 0.001), patients aged ≥22 and < 22 years (16% vs. 44%, respectively;
p < 0.001), and smokers and nonsmokers (13% vs. 43%, respectively; p < 0.001). There were also significant
differences in the multivariate analysis (p < 0.001, p=0.050, and p=0.001, respectively). In the surgery
group, the PSP recurrence rate was significantly different between patients aged ≥22 and < 22 years (7% vs.
38%, respectively; p < 0.001) and smokers and nonsmokers (5% vs. 33%, respectively; p=0.002). No significant
differences were found in the non-surgery group.
Conclusions: In the surgical treatment of PSP, it is desirable that smokers stop using tobacco and that patients are
≥22 years old. Moreover, when surgery is being considered, the best timing seems to be when air leakage is
present because the air leakage sites can be resected.