Contralateral recurrence of primary spontaneous pneumothorax

Tsai Wang Huang, Shih Chun Lee, Yeung Leung Cheng, Ching Tzao, Hsian He Hsu, Hung Chang, Jen Chih Chen

Research output: Contribution to journalArticlepeer-review

68 Citations (Scopus)


Background: Primary spontaneous pneumothorax (PSP) is a common disease in young adults. With advances in its surgical treatment, ipsilateral recurrence is < 5%. However, contralateral recurrence remains a significant problem. The purpose of this retrospective study was to identify the factors associated with contralateral recurrence of PSP. Methods: From January 1997 to December 1999, 231 patients with PSP were reviewed and evaluated after an average of 92-months of follow-up. The clinical features and treatment of these patients were analyzed retrospectively. Results: Thirty-three of these patients had contralateral recurrence (14.3%). The average time of contralateral recurrence was 22.94 months. In the univariate analysis (after Bonferroni correction), patients with contralateral recurrence of PSP had lower a body mass index (BMI) [p < 0.001], and higher frequency of contralateral blebs/bullae on high-resolution CT (HRCT) of the lung (p < 0.001). Multiple logistic regression was performed on 128 patients with contralateral blebs/bullae on HRCT of the lung, and the results indicate that being underweight (BMI < 18.5 kg/m2) is an independent risk factor for contralateral recurrence (odds ratio, 5.327). All patients with contralateral recurrence of PSP received surgical treatment. Two patients had unilateral recurrences of pneumothorax during follow-up (2 of 64 video-assisted thoracoscopic surgeries, 3%). Conclusions: Contralateral recurrence of PSP is significantly more common in patients with underweight and blebs/bullae in the contralateral lung. Single-stage bilateral surgery may be considered for these patients to circumvent the need for subsequent anesthetic and operative procedures, and additional hospitalization.

Original languageEnglish
Pages (from-to)1146-1150
Number of pages5
Issue number4
Publication statusPublished - Oct 2007
Externally publishedYes


  • Bleb
  • Bulla
  • Contralateral recurrence
  • Primary spontaneous pneumothorax
  • Video-assisted thoracoscopic surgery

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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