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This Article Full Text (PDF) Free All Versions of this Article: chest.06-2772v1 132/4/1146    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Huang, T.-W. Articles by Chen, J.-C. Search for Related Content PubMed PubMed Citation Articles by Huang, T.-W. Articles by Chen, J.-C. Related Content Related Editorial

Contralateral Recurrence of Primary Spontaneous Pneumothorax

¹Division of Thoracic Surgery, Department of Surgery ²Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC

ndmc0928{at}yahoo.com.tw

Abstract

BackgroundPrimary spontaneous pneumothorax (PSP) is a common disease in young adults. With advances in its surgical treatment, ipsilateral recurrence is less than 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.

MethodsFrom January 1997 to December 1999, 231 patients with PSP were reviewed and evaluated after an average of 92-month follow-up. The clinical features and treatment of these patients were analyzed retrospectively.

ResultsThirty-three of these patients developed 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 body mass indices (BMI) (p < 0.001), and higher frequency of contralateral blebs/bullae on 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 indicated that underweight (BMI < 18.5 kg/m²) is the 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 VATS, 3%).

ConclusionsContralateral 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.

Key Words: primary spontaneous pneumothorax • contralateral recurrence • bleb • bulla • video-assisted thoracoscopic surgery

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To Bleb or Not To Bleb?

Michael H. Baumann
Chest 2007 132: 1110-1112. [Full Text] [PDF]

This article has been cited by other articles:

				A. I. Hatzitolios, G. Ntaios, M. L. Sion, and Y.-L. Cheng Both Spontaneous Pneumothorax and Spontaneous Pneumomediastinum May Constitute a Complication in Underweight Patients Chest, July 1, 2008; 134(1): 216 - 217. [Full Text] [PDF]

				M. H. Baumann To Bleb or Not To Bleb? Chest, October 1, 2007; 132(4): 1110 - 1112. [Full Text] [PDF]