Læknablaðið - 01.06.2022, Blaðsíða 37

L ÆKNABL AÐIÐ 2022/108 305
R A N N S Ó K N
Heimildir
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E N G L I S H S U M M A R Y
Þórdís Magnadóttir1
Leon Arnar Heitmann2
Tinna Harper Arnardóttir1
Tómas Þór Kristjánsson1
Per Martin Silverborn1
Martin Ingi Sigurðsson2,3
Tómas Guðbjartsson1,2
1Departments of Cardiothoracic Surgery, Landspitali University
Hospital, 2Faculty of Medicine, University of Iceland, 3Anesthesia and
Intensive Care, Landspitali University Hospital.
Correspondence: Tómas Guðbjartsson, tomasgud@landspitali.is
Key words: primary spontaneous pneumothorax, outcomes, recurrence,
smoking.
Short- and long-term outcomes following surgery for primary spontaneous
pneumothorax in Iceland
BACKGROUND: 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.
MATERIALS AND METHODS: 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.
RESULTS: 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 (<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.
CONCLUSIONS: 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.
doi 10.17992/lbl.2022.06.696