title: Pneumothorax recurrence after surgery in women: clinicopathologic characteristics and management.
abstract: BACKGROUND
  Our aim was to study the clinical, surgical, and pathological characteristic of women with homolateral recurrence of pneumothorax despite previous surgery.
  
  
  METHODS
  This study is a retrospective analysis of the clinical and pathological records of all consecutive women of reproductive age hospitalized in a thoracic surgery department for surgical treatment of pneumothorax recurrence despite previous surgery between 2000 and 2009.
  
  
  RESULTS
  During the study period, 35 women were operated on. Their mean age was 37 years. Twenty-nine pneumothoraces (83%) were right sided. In 20 women, the recurrence occurred during the menstrual period. At initial surgery, 5 cases had been catamenial with evidence of thoracic endometriosis, 12 were catamenial with no evidence of endometriosis, 5 were noncatamenial with thoracic endometriosis, and 13 were idiopathic. At repeat surgery the figures were 18, 4, 5, and 8 cases, respectively. Repeat operation was carried out by video-assisted thoracoscopy in 13 cases, video-assisted minithoracotomy in 10, and standard thoracotomy in 12. Partial diaphragmatic resection was performed at repeat surgery in 16 patients (45.7%). Talc pleurodesis and pleural abrasion were carried out in 20 (57.1%) and 15 patients (42.9%), respectively. No major morbidity was observed. After repeat surgery, hormonal treatment was prescribed in 24 cases. Median follow-up was 40 months (range, 1.5 to 138 months). In 6 women, further homolateral recurrence of pneumothorax occurred (17.1%) and required surgery in 3 cases.
  
  
  CONCLUSIONS
  Repeat surgery can be safely performed in women with recurrence of pneumothorax despite previous surgery, and frequently shows initially missed endometriosis.
authors: Department of Thoracic Surgery, Hôtel-Dieu University Hospital, Paris V University, Paris, France. marco.alifano@htd.aphp.fr
authors: Marco
authors: M
authors: Alifano
authors: Antoine
authors: A
authors: Legras
authors: Christine
authors: C
authors: Rousset-Jablonski
authors: Antonio
authors: A
authors: Bobbio
authors: Pierre
authors: P
authors: Magdeleinat
authors: Diane
authors: D
authors: Damotte
authors: Nicolas
authors: N
authors: Roche
authors: Jean-François
authors: JF
authors: Regnard
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004715:Endometriosis / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome