Risk Behavior in Patients Operated for Spontaneous Pneumothorax

Objectives: Spontaneous pneumothorax (PTX) is a common disease frequently operated at specialized thoracic surgery units. It may arise in adolescents with healthy lung tissue (primary PTX) or in elder patients with preexisting lung disease (secondary PTX). Videothoracoscopic surgery (VATS) has become the surgical standard for treatment and recurrence prevention. While there is broad consensus regarding indications and techniques of PTX surgery, potential postoperative risks and consecutive patient behavioral advice have not been sufficiently elucidated to date. Methods: Single-center cohort analysis of 646 patients operated for primary PTX by VATS over a time period of 10 years. Putatively recurrence prone lifestyle activities (smoking status, flying habits, scuba diving) and actual occurrence of recurrences were correlated. Results: Follow up rate was 43% (279/646 patients). Mean time interval between primary operation and follow up was 61 (range 5–177) months. In 10 patients (3.6%), a PTX recurrence was observed. Regarding postoperative risk behavior reported at follow-up, 28% of patients were active smokers (in average 15 ± 7 cigarettes/day), 59% travelled by plane repeatedly, and only 2 patients did scuba diving (0.7%). Neither smoking nor flying or scuba diving could not be identified as statistically significant risk factors for PTX recurrence. Conclusions: In our study, none of the supposed “classic” lifestyle-associated risk factors for PTX recurrence after VATS proved to be a significant threat. Thus, postoperative patient behavior might not necessarily be constrained by overcautious medical advice.