Short- and long-term outcomes following surgery for primary spontaneous pneumothorax in Iceland

Short- and long-term outcomes following surgery for primary spontaneous pneumothorax in Iceland

Primary spontaneous pneumothorax (PSP) is a common disease where surgery is indicated for persistant air leak or recurrent pneumothorax. We studied the outcomes of PSP-surgery over a 28 year period in a whole nation. A retrospective study on 386 patients (median age 24 years, 78% males) that underwe...

Full description

Saved in:
Bibliographic Details
Published in:Laeknabladid Vol. 108; no. 6; pp. 299 - 305
Main Authors: Magnadottir, Thordis, Heitman, Leon Arnar, Arnardottir, Tinna Harper, Kristjansson, Tomas Thor, Silverborn, Per Martin, Sigurdsson, Martin Ingi, Gudbjartsson, Tomas
Format: Journal Article
Language:English
Icelandic
Published: Iceland 01-06-2022
Subjects:
Adult
Female
Humans
Iceland - epidemiology
Male
Pneumothorax - diagnosis
Pneumothorax - epidemiology
Pneumothorax - surgery
Recurrence
Retrospective Studies
Thoracic Surgery, Video-Assisted - adverse effects
Thoracic Surgery, Video-Assisted - methods
Treatment Outcome
Young Adult
Iceland
recurrence
outcomes
primary spontaneous pneumothorax
smoking
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Primary spontaneous pneumothorax (PSP) is a common disease where surgery is indicated for persistant air leak or recurrent pneumothorax. We studied the outcomes of PSP-surgery over a 28 year period in a whole nation. A retrospective study on 386 patients (median age 24 years, 78% males) that underwent 430 PSP surgeries at Landspitali University Hospital 1991-2018. Annual incidence of the procedure was calculated and previous medical history, indication and type of surgery, complications and length of hospital stay were registered. Patients in four 7 year periods were compared, recurrent pneumothoraces requiring reoperation (median follow-up 16 years) registered and predictors of reoperation identified with logistic regression. Annually 14.5 PSP surgeries (median, range 9-27) were performed; the incidence decreasing by 2.9% per year on average. Every other patient smoked and 77% of surgeries were performed with video assisted thoracocopic surgery (VATS). The most common early complications (p<30 days from surgery) were persistent airleak (17%), pneumonia (2%) and empyema (0,5%). No patient died within 30 days from surgery. Reoperation for recurrent pneumothorax was performed on 27 patients; 24 following VATS (7%), median time from the primary surgery being 16 months. Logistic regression showed that younger patients were more likely to require reoperation for recurrent pneumothorax. Surgical treament for PSP is safe and major early complications rare. The rate of recurrent pneumothorax requiring surgery was 6%, which is similar to other studies. For unknown reasons the incidence of PSP surgery declined, but future research has to answer if it is linked to decreased smoking in the Icelandic population.
ISSN:0023-7213
1670-4959
DOI:10.17992/lbl.2022.06.696