Approach to patients with secondary spontaneous pneumothorax: Our clinical experience.

Objective: In this study, our aim is to analyze the etiological causes and treatment methods of patients with secondary spontaneous pneumothorax treated in our hospital. Method: We retrospectively evaluated the data of 152 patients who were treated for Secondary spontaneous pneumothorax between January 2013 - December 2017. All patients diagnosed with SSP were included in the study. The patients were examined in terms of age, gender, current lung disease, smoking, symptoms, imaging findings, localization of pneumothorax, pneumothorax rate, treatment methods, surgical indications, length of hospitalisation and mortality rate. Results: One hundred and twenty eight (84.2%) of 152 patients were men, 24 were women (15.8%) and their mean age was 66 ± 12.4 (45--98). The most common symptoms were dyspnoea in 114 (75%) patients, chest pain in 85 (55.9%) patients and cough in 26 (17.1%) patients. The most common comorbid pathology was Chronic obstructive pulmonary disease (COPD) in 39.5% patients. Tube thoracostomy was performed in 6 (40%) of 15 (9.9%) patients who were monitored with oxygen therapy. While 112 (73.7%) patients were treated with tube thoracostomy only, 36 (32.1%) of them who were inoperable were treated with pleurodesis by tube thoracostomy. Thirty one (20.4%) patients were treated surgically, of which video-assisted thoracoscopic was performed in 17 (54.8%) and thoracotomy in 14 (45.2%). The majority of our surgical indications were prolonged air leak and recurrent pneumothorax. Conclusions: Despite the great advances in surgical techniques in thoracic surgery in recent years, a standard treatment protocol has not been established in the treatment of SSP. While pneumothorax can be treated with only chest tube and/or pleurodesis in most patients, morbidity and mortality may increase with surgical treatment. Therefore, surgical treatment should be avoided as much as possible. [ABSTRACT FROM AUTHOR]