title: Complete atelectasis of the lung in patients with primary spontaneous pneumothorax.
abstract: BACKGROUND
  Complete atelectasis of primary spontaneous pneumothorax (PSP) requires immediate air reduction. Surgical intervention has been considered proper treatment for persistent air leakage or recurrence. We examined whether this is the proper treatment by evaluating the natural course and treatment outcomes of complete lung atelectasis.
  
  
  METHODS
  We retrospectively analyzed the records of 286 patients with a first episode of PSP. We classified patients as partial atelectasis (n = 201, 71%) and complete atelectasis (n = 85, 29%) by initial radiography. Surgical intervention was done for persistent air leakage or recurrence, and all surgery was performed by video-assisted thoracoscopic surgery. We compared both groups for demographic and operative variables.
  
  
  RESULTS
  In all, 29.4% of the complete atelectasis group and 10% of the partial atelectasis group showed persistent air leakage. The ipsilateral recurrence rate was 70% for the complete atelectasis group and 39.2% for the partial atelectasis group. Video-assisted thoracoscopic surgery was performed in 78.8% and 45.3% of the complete atelectasis and partial atelectasis groups, respectively. The postoperative course and recurrence rate were not different between the two groups during 40.2 months of follow-up.
  
  
  CONCLUSIONS
  The PSP patients with complete atelectasis showed a higher incidence of persistent air leakage and ipsilateral recurrence than did PSP patients with partial atelectasis. Operative outcomes were good. Complete atelectasis of the lung in PSP patients is an indication for surgical intervention at their first PSP episode.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Dankook University Hospital, Cheonan, Korea. cskmin@naver.com
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Ryu
authors.forename: Pil Won
authors.initials: PW
authors.lastname: Seo
authors.forename: Seongsik
authors.initials: S
authors.lastname: Park
authors.forename: Jae-Wook
authors.initials: JW
authors.lastname: Ryu
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D011030:Pneumothorax / Q000150:complications* / Q000601:surgery*; D001261:Pulmonary Atelectasis / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult