Treatment of Secondary Spontaneous Pneumothorax: 100-Patient Experience

Objective: Secondary spontaneous pneumothorax (SSP) was defined as air accumulation in the pleural space in the presence of obvious underlying lung disease. The purpose of this study was to evaluate the etiology, clinical features, treatment, and the results of SSP in the light of literature data. Materials and methods: Between January 1998 and January 2007, 100 patients who were diagnosed and treated with SSP in our clinic were compiled retrospectively. Age, gender, underlying lung disease, smoking history, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality, and hospital stay of the patients were reviewed. Results: Hundred patients with 120 pneumothoraces were included in the study. Of the patients, 87 (87%) were males and 13 (13%) were female. The mean age was 47.3 +/- 20.9 years (1-84 years). The most common pre-existing lung diseases responsible for pneumothorax was COPD (40%) and followed by bullous emphysema (25%). Whereas 48 patients (48%) were managed by tube thoracostomy, 21 patients were managed by tube thoracostomy+pleurodesis. Thirty-one patients underwent surgery. Operative indications were prolonged air leak (n=18) and bullae + recurrence (n=7). Hospital mortality was %6. The mean postoperative hospitalization time of the patients was 15.0 +/- 14.4 days (range: 1-94 days). Conclusion: An urgent and effective treatment requires in the patients with SSP. We believe that the first treatment option should be tube thoracostomy in patients with SSP, as the patients mostly have increased operative risk due to advanced age and lung disease.