Original articleGeneral thoracicRole of Blebs and Bullae Detected by High-Resolution Computed Tomography and Recurrent Spontaneous Pneumothorax
Section snippets
Material and Methods
This study was approved by the University of Modena and Reggio Emilia Ethics Committee, and individual consent to study participation was obtained from all patients.
Results
Data for 199 patients were recorded. Of these, 8 were lost to follow-up, and 15 underwent surgical intervention after the first PSP and were excluded from the analysis. Therefore, the study population comprised 176 patients. Their clinical characteristics are reported in Table 1 and HRCT findings in Table 2.
Mean time to ipsilateral recurrence was 12.8 months (range, 1 to 64 months). Mean time to contralateral recurrence was 41.7 months (range, 6 to 97 months). For patients who did not
Comment
Surgical therapy, consisting of blebs excision with pleurodesis, currently represents the most effective method for preventing recurrence [3, 4]. Although the video-assisted thoracoscopic procedure shows a fourfold increase in recurrence rate compared with an open operation [11], it is now preferred over a traditional open approach because of the shorter hospital stay, lower pain, and more favorable cost-effectiveness ratio [11, 12, 13].
At present, the need to prevent recurrence after a first
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Cited by (81)
Not all Blebs Are Created Equal
2022, ChestNatural History of Contralateral Bullae/Blebs After Ipsilateral Video-Assisted Thoracoscopic Surgery for Primary Spontaneous Pneumothorax: A Retrospective Cohort Study
2022, ChestCitation Excerpt :However, Jang et al12 described contralateral bullae/blebs as both asymptomatic and without a history of rupture. Potential differences between ruptured and unruptured bullae were described by Casali et al.14 They examined HRCT images obtained after the first episode of PSP after excluding ipsilateral or bilateral VATS. Of 176 patients, 44.8% experienced ipsilateral recurrence and 12% experienced contralateral recurrence.
PRIMARY SPONTANEOUS PNEUMOTHORAX WITH AN APICAL BLEB: CONTROVERSIES IN WORKUP AND MANAGEMENT
2022, Journal of Emergency MedicineContemporary Role of Computed Tomography in Managing Pediatric Primary Spontaneous Pneumothorax
2022, Journal of Surgical ResearchCitation Excerpt :Computed tomography (CT) is an imaging modality that has been used to evaluate for bleb disease in patients presenting with pneumothorax (PTX). Some authors have advocated the identification of bullae on CT as an indication for surgical intervention.4-6 There is an ongoing debate on the pediatric PSP literature regarding the utility of CT scan in diagnosing bleb disease and predicting recurrence.6-8