A comparative study of surgical outcomes for secondary spontaneous pneumothorax and the postoperative survival prognostic factor: interstitial vs. non-interstitial pneumonia

Masafumi Noda; Ken Onodera; Tatsuaki Watanabe; Yui Watanabe; Hirotsugu Notsuda; Takaya Suzuki; Hisashi Oishi; Hiromichi Nikawa; Yoshinori Okada

doi:10.1007/s11748-023-02000-y

A comparative study of surgical outcomes for secondary spontaneous pneumothorax and the postoperative survival prognostic factor: interstitial vs. non-interstitial pneumonia

Gen Thorac Cardiovasc Surg. 2024 Jan 12. doi: 10.1007/s11748-023-02000-y. Online ahead of print.

Authors

Masafumi Noda¹, Ken Onodera², Tatsuaki Watanabe², Yui Watanabe², Hirotsugu Notsuda², Takaya Suzuki², Hisashi Oishi², Hiromichi Nikawa², Yoshinori Okada²

Affiliations

¹ Department of Thoracic Surgery, Aging and Cancer, Institute of Development, Tohoku University, Sendai, Japan. masafumi.noda.a3@tohoku.ac.jp.
² Department of Thoracic Surgery, Aging and Cancer, Institute of Development, Tohoku University, Sendai, Japan.

PMID: 38214883
DOI: 10.1007/s11748-023-02000-y

Abstract

Purpose: To investigate the surgical outcomes and postoperative survival prognostic factors of intractable secondary spontaneous pneumothorax.

Methods: A total of 95 patients who underwent thoracoscopic surgery for intractable secondary spontaneous pneumothorax between April 2010 and March 2020 were included in this study. These patients were classified into interstitial pneumonia and non-interstitial pneumonia groups, and a comparative study was performed on surgical outcomes and postoperative survival prognostic factors.

Results: There was no difference in the 1-year overall survival rate between the two groups. However, the 3-year overall survival rate was significantly lower in the interstitial pneumonia group than in the non-interstitial pneumonia group. The differences in short-term surgical outcomes (persistent air leakage, postoperative complications, etc.) were not significant between the two groups. Univariate analysis revealed that the drainage period, the development of postoperative complications, and recurrence were significant independent postoperative survival prognostic factors for all cases. Postoperative complications were the only associated postoperative survival prognostic factor for interstitial pneumonia pneumothorax in the multivariate analysis.

Conclusion: The development of postoperative complications can cause poor postoperative survival prognosis of intractable secondary spontaneous pneumothorax due to interstitial pneumonia.

Keywords: Idiopathic pulmonary fibrosis; Interstitial pneumonia; Intractable pneumothorax; Persistent air leakage (PAL); Postoperative survival prognostic factor.