Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax in children

There is controversy regarding the best way to prevent recurrences of primary spontaneous pneumothorax (PSP) in children. The purpose of this study was to evaluate the efficacy of video-assisted thoracoscopic surgery (VATS) for pediatric PSP. We retrospectively reviewed patients under 29 years of age who underwent VATS for PSP between March 2005 and February 2011. Patients were divided into 2 groups: children (under the age of 17 years) and young adults (over the age of 18 years). Two hundred eighty-one VATS procedures in 257 patients were included in this study. The mean follow-up was 47.1 +/- A 20.5 months. No mortality was observed. The mean duration of pleural drainage was 3.4 +/- A 2.2 days. The overall recurrence rate was 6.8 %. The operative outcomes did not differ significantly. However, the recurrence rate was significantly higher in the children's group than the young adult group (10.6 vs. 3.9 %, P = 0.032). Younger age and postoperative prolonged air leak had a significantly higher risk of postoperative recurrence. VATS is a safe and effective procedure for PSP in children. However, the risk of recurrence is increased in children and it is related to the formation of new bullae.