title: [Surgical treatment of recurrent spontaneous pneumothorax: what is the optimal timing?].
abstract: OBJECTIVE
  To analyze the impact on the outcome of video-assisted thoracoscopic surgery (VATS) of delaying surgery in patients with previous episodes of pneumothorax.
  
  
  METHODS
  We studied 57 surgical procedures for recurrent primary spontaneous pneumothorax. The cases were grouped according to the medical history. One group comprised patients treated surgically at the first episode of contralateral pneumothorax or the second episode of ipsilateral pneumothorax. The second group comprised patients treated surgically at the third or successive episode. We compared the 2 groups as to number of thoracotomies, number of conversions from VATS to thoracotomy, presence of adhesions, and length of postoperative hospital stay.
  
  
  RESULTS
  Of the total number of procedures, 13.9% were performed during the third or successive episode. In this group the number of pleuropulmonary adhesions and the percentage of thoracotomies (whether initially indicated or conversions from VATS) was significantly higher (P<.05). However, there was no difference between the 2 groups in length of postoperative stay.
  
  
  CONCLUSIONS
  VATS is the technique of choice for the surgical treatment of recurrent primary spontaneous pneumothorax. Such treatment should be performed at the first episode of contralateral pneumothorax or the second episode of ipsilateral pneumothorax since delayed surgery gives rise to a higher incidence of technical difficulties that entail thoracotomies.
authors.affiliation: Servicio de Cirugía Torácica, Complexo Hospitalario Xeral-Cíes, Vigo, Pontevedra, España. eduardorivo@yahoo.es
authors.forename: J E
authors.initials: JE
authors.lastname: Rivo Vázquez
authors.forename: M A
authors.initials: MA
authors.lastname: Cañizares Carretero
authors.forename: E
authors.initials: E
authors.lastname: García Fontán
authors.forename: J
authors.initials: J
authors.lastname: Albort Ventura
authors.forename: R
authors.initials: R
authors.lastname: Peñalver Pascual
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011030:Pneumothorax / Q000601:surgery*; D012008:Recurrence; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors; D016896:Treatment Outcome