Surgical Outcomes in Secondary Spontaneous Pneumothorax and Prognostic Factors of Disease Recurrence
Sira Laohathai, MD1, Jakraphan Yu, MD1, Chanyapat Kaewsaengeak, MD2
Affiliation : 1Cardio Thoracic Surgery Unit, Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, 2Cardio Thoracic Surgery Unit, Department of Surgery, Police Hospital, Bangkok, Thailand
Background: Treating secondary spontaneous pneumothorax (SSP) is challenging owing to its association with underlying lung diseases and potential life-threatening complications. Surgical intervention is usually not recommended because of the poor outcome.
Materials and Methods: We conducted a retrospective analysis of 92 patients who underwent surgical treatment for SSP at Vajira Hospital between January 2020 and May 2023. Ethical approval for the study was obtained from the institutional review board (221/66 E). We routinely perform lung bullectomy and pleurodesis. Patient demographics, surgical procedures, postoperative outcomes, and survival rates were analyzed. Using univariate analysis, we identified prognostic factors associated with recurrence pneumothorax.
Results: Most patients were male (83%), with a median age of 52 years. Chronic obstructive pulmonary disease was the most common underlying disease (28%), followed by tuberculosis (21%) and lung cancer (3%). Video-assisted thoracoscopic surgery was the primary surgical approaches, with bullectomy and pleurodesis performed in most cases. Disease-free survival rates at 12 and 36 months were 97.5% and 93.1%, respectively. Dyslipidemia, diabetes, and cardiovascular disease were identified as significant prognostic factors for disease recurrence.
Conclusion: Surgical treatment for SSP demonstrated favorable outcomes, with high overall survival rates and a low incidence of postoperative complications. Treatment should be optimized based on the patient’s condition and underlying comorbidities.
Received 26 April 2024 | Revised 2 July 2024 | Accepted 16 July 2024
Keywords : Video assisted thoracoscopic surgery; Secondary pneumothorax; Open thoracotomy
