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Recurrence of primary spontaneous pneumothorax in young adults and children

Authors
 Dongsub Noh  ;  Sungsoo Lee  ;  Seok Jin Haam  ;  Hyo Chae Paik  ;  Doo Yun Lee 
Citation
 Interactive Cardiovascular and Thoracic Surgery, Vol.21(2) : 195-199, 2015 
Journal Title
 Interactive Cardiovascular and Thoracic Surgery 
ISSN
 1569-9293 
Issue Date
2015
Abstract
OBJECTIVES: Although better nutritional support has improved the growth rates in children, the occurrence of primary spontaneous pneumothorax has also been increasing in children. The current study attempts to investigate the occurrence and recurrence of primary spontaneous pneumothorax and the efficacy of surgery for primary spontaneous pneumothorax in young adults and children. METHODS: A total of 840 patients were treated for pneumothorax at our hospital from January 2006 to December 2010. Exclusion criteria for this study were age >25 or secondary, traumatic or iatrogenic pneumothorax, and a total of 517 patients were included. Patients were classified into three groups according to age at the first episode of primary spontaneous pneumothorax: Group A: ≤16 years; Group B: 17-18 years and Group C: ≥19 years. RESULTS: The study group was composed of 470 male and 47 female patients. There were 234 right-sided, 279 left-sided and 4 bilateral primary spontaneous pneumothoraces. Wedge resection by video-assisted thoracic surgery was performed in 285 patients, while 232 were managed by observation or closed thoracostomy. In the wedge resection group, 51 patients experienced recurrence. The recurrence rates after wedge resection were 27.9% in Group A, 16.5% in Group B and 13.2% in Group C (P = 0.038). The recurrence rates after observation or closed thoracostomy were 45.7% in Group A, 51.9% in Group B and 47.7% in Group C (P = 0.764). CONCLUSIONS: In the present study, postoperative recurrence rates were higher than those in the literature. Intense and long-term follow-up was probably one reason for the relatively high recurrence rate. The recurrence rate after wedge resection in patients aged ≤16 years was higher than that in older patients. There was no difference between the recurrence rates after observation or closed thoracostomy, regardless of age. These results suggest that wedge resection might be delayed in children.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141520
DOI
10.1093/icvts/ivv104
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
Yonsei Authors
노동섭(Noh, Dong Sub) ; 백효채(Paik, Hyo Chae) ; 이성수(Lee, Sung Soo) ; 함석진(Haam, Seok Jin)
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Full Text
http://icvts.oxfordjournals.org/content/21/2/195.long
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