Usefulness of Computed Tomography in Determining Risk of Recurrence After a First Episode of Primary Spontaneous Pneumothorax: Therapeutic Implications

Martínez-Ramos, David; Ángel-Yepes, Vicente; Escrig-Sos, Javier; Miralles-Tena, Juan Manuel; Salvador-Sanchís, José Luis

doi:10.1016/s1579-2129(07)60075-5

Cited by 37 publications

(37 citation statements)

References 21 publications

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“…The role of blebs/bullae as a preexistent lesion for development of PSP has been questioned; in fact, some studies observed no correlation between its presence and the risk for PSP recurrence (6,8,9,11,12,(14)(15)(16)(17). However, there is some evidence on the lack of association between blebs and different recurrent patterns of PSP (ipsilateral or contralateral).…”

Section: Discussionmentioning

confidence: 99%

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

Chen¹,

Huang²,

Chang³

et al. 2016

J. Thorac. Dis.

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IntroductionPrimary spontaneous pneumothorax (PSP) usually occurs in young, tall, and lean men, especially smokers with no obvious underlying lung disease. It arguably results from rupture of subpleural blebs or bullae. The most frequent complication of PSP is recurrence, which is estimated to occur in 20% to 60% after conservative treatment (1,2). More than 50% of patients with PSP have contralateral blebs/bullae and about a quarter will develop contralateral pneumothorax (3). The British Thoracic Society (BTS) guidelines include first recurrence of contralateral pneumothorax and synchronous bilateral PSP as the only indications for surgery of the contralateral lung (4). However, surgery of the contralateral lung to prevent possible complications remains controversial (5-7). To date, only few studies on small populations have discussed both ipsilateral and contralateral recurrences of PSP. The purpose of our study was to identify the predictors of ipsilateral and contralateral recurrences of PSP and to review literatures on the association of blebs/bullae on high resolution computed tomography (HRCT) of the chest with PSP recurrence. Knowing the risk factors for PSP recurrence may enable us to optimize patient selection to avoid further recurrence and complications.

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Section: Discussionmentioning

confidence: 99%

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

Chen¹,

Huang²,

Chang³

et al. 2016

J. Thorac. Dis.

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“…However, the role of bullae or blebs in the development of recurrent pneumothorax is unclear, and some authors proposed that the decision for surgical intervention should be based on documented recurrence only. 5,10,20,21) The incidence of blebs/bullae on HRCT scans in paediatric population studies was reported to range from 30.8% to 100%, 6,14,17,19,20,22) and the recurrence rate after conservative treatment in patients with air-containing lesions was reported to range from 50% to 100% (Table 4). 6,17,19) These results are consistent with the results of our study of an incidence of blebs/bullae on HRCT scans of 55.3% (63/114) and the 60.3% recurrence rate associated with blebs/bullae on HRCT scans.…”

Section: Discussionmentioning

confidence: 99%

“…The adult literature has reported rates of air-containing lesions on CT scans of 47% to 88%. [8][9][10]23) Moreover, some adult series documented that the air-containing lesions on CT were an independent risk factor. 8,24) The sensitivity of the plain chest X-ray for detecting the underlying cause of PSP is very low (approximately 15%).…”

Section: Discussionmentioning

confidence: 99%

“…We adopted a scoring system to better assess the severity of pulmonary lesions, and this system has been previously described. [8][9][10] This dystrophic severity score was calculated for each patient using the HRCT scans as follows: different values were assigned according to the type (1 or 2 points for blebs or bullae), number (1 or 2 points for single or multiple lesions), and distribution (1 or 2 points for unilateral or bilateral lesions) of the air-containing pulmonary lesions. This score has a maximum of 6 points and a minimum of 3 points.…”

Section: Methodsmentioning

confidence: 99%

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

Choi

Park

Song

et al. 2014

ATCS

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“…In our patients, the site, abondance of PNX, primary or secondary caracter, and the therapeuticmeans of first episode (53% were exsufflated and 47% drained) seem not to influence the recurrence. The input of Thoracic CT-scan in the evaluation of recurrence risk after a first episode of PNX wasn't clearly demonstrated [7,8].The results of studies realized byOuannes et al [8] and MartinezRamos and al [9], couldn't demonstrate that the presence, the size or the bubbles nomber on the CT-scan have an influence on the recurrence rate. As well as, in our series, we didn't establish this relationship.…”

Section: Discussion:-mentioning

confidence: 99%

Factors Predicting Pneumothorax Reccurence.

Moubachir¹,

Janah²,

Jabri³

et al. 2017

IJAR

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Summary:Recurrence is the main risk of progression of spontaneous pneumothorax (PNX).The recurrence rate varies according to the authors between 20 and 60%. To determine the factors predicting recurrence of pneumothorax in our population, a retrospective analytical study was conducted over a period of five years between April 2010 and 2016, covering 46 cases of patients hospitalized for recurrentspontaneous pneumothorax. The smoking status of patients, the profession and the non-respect of hygiene rules remain in our context the main predictive factors for recurrence. …………………………………………………………………………………………………….... Introduction:-The PNX is defined as the presence of air in the pleural space. It'sa frequent pathologyof which the recurrence is the main evolutive risk, life threatening of the patient. The risk is increased by a variety of factors, which the identification helps to indicate some preventive measures. Materials and methods:-It's a retrospective analytical studyover a five-year period, between April 2010 and 2016, conducted on 46 files of patients hospitalized for spontaneous pneumothorax recurrence. The PNX is considered primary or secondary depending on the existence or not of an underlying respiratory pathology. Excluded from the study, traumatic PNX, iatrogenic and the patients who kept a detachment on the first episode. The objective of our work is to specify the recurrence predictive factorsin our population. Results:-The recurrent PNX present 19% (46 cases) of the whole hospitalized PNX during the study period. The average age was of 42 years old with a male dominance (44 men for 2 women). The active smoking was noted in 77% of patients (35 cases) with an average of 39 pack-years of cigarettes, associated to cannabis in 32% (15 cases). The average age of the beginning of toxic habits was 18 years old with extreme between 14 and 22 years old. In 60% of cases, patients had job requiring important physical efforts (butcher, mechanic) with impossibility of changing their job, which was linked to the recurrence in 87% (23 cases). In their medical history, 20% of patients (9 cases) were followed for chronic obstructive pneumonia, two patients (4%) were having uncontrolled asthma, five (11%) were treated for pulmonary tuberculosis, one patient had a cardiopathy and another one was followed for Behcet disease.The Thoracic CT-scan realized remotelyfrom the PNX episode in 55% of patients (25 cases) had objectivated pulmonary emphysema in 53% (24 cases), sequalae cavities in 7% (15 cases) and blebs in 9 cases (19%). The PNX was considered primary in 73% and secondary in 27%. The average between the two episodes was

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Usefulness of Computed Tomography in Determining Risk of Recurrence After a First Episode of Primary Spontaneous Pneumothorax: Therapeutic Implications

Cited by 37 publications

References 21 publications

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

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

Factors Predicting Pneumothorax Reccurence.

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