AI Article Synopsis
- * Results show that while surgical treatment significantly reduces recurrence on the same side (ipsilateral), it increases the likelihood of recurrence on the opposite side (contralateral).
- * The authors recommend conservative treatment as the preferred option for first-time spontaneous pneumothorax in adolescents, suggesting that routine CT scans should be avoided.
Article Abstract
Objectives: Controversy exists regarding the justification of primary surgery in primary spontaneous pneumothorax, and surgery is not free from recurrence. We hypothesized that surgery is a risk factor for contralateral recurrence pneumothorax in adolescent.
Methods: We performed a retrospective cohort study of 163 adolescent with pneumothorax who were treated conservatively with chest tube (n = 100) or chest tube followed by video-assisted thoracoscopic surgery (n = 63) from January 2009 through December 2017.
Results: Ipsilateral recurrence was significantly more common following conservative treatment than surgical treatment (25.0 vs. 3.2%, P < 0.001), while contralateral recurrence was more common in the surgical group than in the conservative group (15.9 vs. 6.0%, P = 0.039). The rates of second episode pneumothorax did not significantly differ between the two treatment groups (P = 0.092). Univariate analysis identified that patients who were treated conservatively had greater risk of ipsilateral recurrence (P = 0.002), while those who proceeded to surgery had greater risk of contralateral recurrence (P = 0.046). No predictors for second episode pneumothorax were found.
Conclusion: To avoid over treatment, we recommend that conservative treatment should be the superior option and CT scan should not be a routine examination in adolescent with their first episode of PSP.
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| http://dx.doi.org/10.1007/s11748-021-01663-9 | DOI Listing |
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