What Factors Predict Recurrence after an Initial Episode of Primary Spontaneous Pneumothorax in Children?

Annals of Thoracic and Cardiovascular Surgery

Online ISSN : 2186-1005
Print ISSN : 1341-1098
ISSN-L : 1341-1098

Original Articles

What Factors Predict Recurrence after an Initial Episode of Primary Spontaneous Pneumothorax in Children?

Si Young Choi, Chan Beom Park, Sun Wha Song, Yong Hwan Kim, Seong Cheol Jeong, Kyung Soo Kim, Keon Hyon Jo

Author information

Si Young Choi
Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
Chan Beom Park
Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary’s Hospital, The Catholic University of Korea College, College of Medicine, Seoul, Korea
Sun Wha Song
Department of Radiology, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
Yong Hwan Kim
Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
Seong Cheol Jeong
Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
Kyung Soo Kim
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
Keon Hyon Jo
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea

Keywords: primary spontaneous pneumothorax, adolescent, recurrence, bullae/bleb, retrospective study

JOURNAL FREE ACCESS

2014 Volume 20 Issue 6 Pages 961-967

DOI https://doi.org/10.5761/atcs.oa.13-00142

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Details

Abstract

Purpose: Recurrence is the most common complication after an initial episode of primary spontaneous pneumothorax (PSP). However, preventive surgery in children remains a controversial issue. The purpose of this study was to determine predictive factors of recurrence to better inform early surgical referrals.Methods: We retrospectively reviewed all consecutive patients under 18 years of age who conservatively treated for an initial episode of PSP between March 2005 and September 2011.Results: One hundred fourteen patients were included in this study. The mean follow-up period was 43.1 months. Ipsilateral and contralateral recurrence developed in 47.3% and 14.0% of patients. The risk of ipsilateral recurrence for patients with or without air-containing lesions according to high-resolution computed tomography (HRCT) was 60.3% and 31.4%. In the multivariate analysis, the presence of air-containing lesions on HRCT scans and bullae on chest X-rays were independent risk factors for ipsilateral recurrence.Conclusion: The presence of bleb or bullae on HRCT scans or chest X-rays after an initial episode of PSP was significantly related to the ipsilateral recurrence in children. If the risk factors are clarified in further studies, hospital stays and the recurrence of PSP after the first episode could be reduced with early video-assisted thoracoscopic surgery.

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© 2014 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/

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