Contralateral recurrence of primary spontaneous pneumothorax

Tsai Wang Huang, Shih Chun Lee, Yeung Leung Cheng, Ching Tzao, Hsian H. Hsu, Hung Chang, Jen Chih Chen

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49 Citations (Scopus)

Abstract

Background: Primary spontaneous pneumothorax (PSP) is a common disease in young adults. With advances in its surgical treatment, ipsilateral recurrence is <5%. However, contralateral recurrence remains a significant problem. The purpose of this retrospective study was to identify the factors associated with contralateral recurrence of PSP. Methods: From January 1997 to December 1999, 231 patients with PSP were reviewed and evaluated after an average of 92-months of follow-up. The clinical features and treatment of these patients were analyzed retrospectively. Results: Thirty-three of these patients had contralateral recurrence (14.3%). The average time of contralateral recurrence was 22.94 months. In the univariate analysis (after Bonferroni correction), patients with contralateral recurrence of PSP had lower a body mass index (BMI) [p <0.001], and higher frequency of contralateral blebs/bullae on high-resolution CT (HRCT) of the lung (p <0.001). Multiple logistic regression was performed on 128 patients with contralateral blebs/bullae on HRCT of the lung, and the results indicate that being underweight (BMI <18.5 kg/m2) is an independent risk factor for contralateral recurrence (odds ratio, 5.327). All patients with contralateral recurrence of PSP received surgical treatment. Two patients had unilateral recurrences of pneumothorax during follow-up (2 of 64 video-assisted thoracoscopic surgeries, 3%). Conclusions: Contralateral recurrence of PSP is significantly more common in patients with underweight and blebs/bullae in the contralateral lung. Single-stage bilateral surgery may be considered for these patients to circumvent the need for subsequent anesthetic and operative procedures, and additional hospitalization.

Original languageEnglish
Pages (from-to)1146-1150
Number of pages5
JournalChest
Volume132
Issue number4
DOIs
Publication statusPublished - Oct 2007
Externally publishedYes

Keywords

  • Bleb
  • Bulla
  • Contralateral recurrence
  • Primary spontaneous pneumothorax
  • Video-assisted thoracoscopic surgery

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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  • Cite this

    Huang, T. W., Lee, S. C., Cheng, Y. L., Tzao, C., Hsu, H. H., Chang, H., & Chen, J. C. (2007). Contralateral recurrence of primary spontaneous pneumothorax. Chest, 132(4), 1146-1150. https://doi.org/10.1378/chest.06-2772