Primary Spontaneous Pneumothorax—Outcomes of Different Treatment Modalities

The aim of this study is to compare the recurrence rates with different modalities used as first-line treatment for first-episode primary spontaneous pneumothorax, and investigated the risk factors for recurrence. We retrospectively reviewed consecutive patients under 60 years of age who were treated for a first episode of primary spontaneous pneumothorax between May 1996 and May 2016 at our hospital. The patients were divided into 6 groups according to the treatment received. A total of 667 patients with 890 episodes of primary spontaneous pneumothorax were included in the analysis. The median follow-up period was 64.5 months. The recurrence rate in the 6 groups was as follows: observation, 52.5% (21/40); chest tube drainage, 32.6% (84/258); aspiration, 100% (42/42); axillary thoracotomy, 8.8% (9/102); 2-port video-assisted thoracoscopic surgery (VATS), 6.0% (7/117); and 3-port VATS, 10.6% (11/108). The recurrence rate was higher in non-surgery groups than in surgery groups (147/340 vs 27/327, P