ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Risk factors, clinical and radiological evaluation in patients with recurrent spontaneous pneumothorax
Burçin Çelik1, Aydın Nadir1, Ekber Şahin1, Melih Kaptanoğlu1, Hasan Demir2, Kamil Furtun2
1Cumhuriyet Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Sivas
2Samsun Göğüs Hastalıkları ve Göğüs Cerrahisi Hastanesi, Göğüs Cerrahisi Kliniği, Samsun
Ba­ckgro­und: Pneumothorax is defined as the presence of air in the pleural cavity. The rate of recurrence of spontaneous pneumothorax (SP) ranges from 16% to 52%. The purpose of this study was to define the clinical features, risk factors and the results of the treatment of recurrent SP.

Metho­ds: We retrospectively evaluated 332 patients with SP, 55 (16.5%) patients (49 males, 6 females; mean age 32.8±13.1 years; range 16 to 76 years) with recurrent SP between April 1996-December 2006. Patients were analyzed according to age, sex, etiology, pneumothorax episodes, radiological and operative findings, treatment and outcomes. All patients had chest radiography on admission. Tube thoracostomy was the initial treatment in all patients at first episode.

Results: Seventy episodes of SP were observed in 55 patients during the study. A right-sided SP was detected in 34 cases (62%), a left-sided SP in 20 cases (36%), and a bilateral SP in one case. Thirty five patients (64%) were smokers, 16 patiens (29%) were nonsmokers. Computed tomography studies on 46 cases of SP were analyzed. Computed tomography demonstrated bleb and/or bullae in 53% of primary SP and 95% of secondary SP. As surgical treatment; 22 patients underwent axillary thoracotomy, 17 patients lateral thoracotomy, and three patients video assisted thoracoscopic surgery. Intraoperative findings showed bleb and/or bullae in 35 patients, no parenchymal lesion in eight patients. Postoperative mortality was zero. The mean hospital stay was 8.1±2.3 days.

Co­nclusio­n: In SP, which factors predict a recurrence is still unclear. In recurrent spontaneous pneumothorax, axillary thoracotomy and video assisted thoracoscopic surgery is a safe surgical approach with satisfactory results.

Keywords : Pneumothorax; spontaneous; recurrent; risk factor; treatment
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