Outcomes of Surgically Treated Pneumothorax in Patients with Interstitial Pneumonia

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Background : Pneumothorax with interstitial pneumonia (IP) is a refractory and life-threatening disease. The aim of the study was to clarify the benefits of surgical treatment of initial-onset pneumothorax in patients with IP.
Methods : The medical records of 37 patients with IP who developed initial-onset pneumothorax were retrospectively reviewed. Two groups of patients were analyzed : a surgical treatment group (n＝20) and a non-surgical treatment group (n＝17). The clinical characteristics of the two groups were compared. Risk factors for respiratory complications in hospital were assessed by univariate and multivariate logistic regression analyses.
Results : A Respiratory complications in hospital in the surgical treatment group included two patients who developed bacterial pneumonia ; however, no patient developed acute exacerbation of IP. The location of air leakage was determined during surgery in 19 of the 20 (95%) patients. Air leakage developed from the bulla in 18 patients and from a crack of the lung parenchyma in one patient. Univariate and multivariate logistic regression analyses showed that surgery was independently associated with a significantly lower risk of respiratory complications in hospital (hazard ratio [HR]＝0.115, p＝0.022).
Conclusion : Surgical treatment yielded relatively better results than non-surgical treatment in patients with IP who develop initial-onset pneumothorax. Surgical treatment should be considered for IP patients who develop pneumothorax.