Polyglactin mesh in preventing recurrent pneumothorax in primary spontaneous pneumothorax: a retrospective efficacy study.

Background: At present, surgical bullectomy together with pleurodesis has the highest efficacy in terms of preventing the recurrence of primary spontaneous pneumothorax (PSP). There is still debate in the type of pleurodesis. In this study, we aim to investigate the efficacy of polyglactin mesh covering comparing to the standard surgical pleurodesis. Methods: This is a retrospective study collecting PSP patients who underwent bullectomy with pleurodesis between January 2016 and August 2023. The patients were divided into two groups as mesh and non-mesh group. Propensity score-matching analysis (1:1) was performed to balance the patient characteristics. The primary outcome was the pneumothorax recurrence after the index operation analyzed by Kaplan-Meier method. Operative and post-operative results were compared using Chi-squared test, Student's Results: There are 151 PSP patients during the study period, 84 and 67 of them were in mesh and non-mesh group respectively. After propensity matched, there were 49 patients in each group. From the Kaplan-Meier analysis with the longest follow-up time as 48 months, as the non-inferiority trial, there was no statistically significant between two groups (P=0.23). Importantly, the mesh group showed lower operative time for 15 minutes (P=0.01), lower blood loss for 10 mL (P<0.001), and shorter duration of chest tube for 1 day (P=0.002). Conclusions: In PSP patients undergoing lung bullectomy with pleurodesis, using of polyglactin mesh coverage the entire lung facilitates less operative time, less intra-operative blood loss and shorter both length of stay and chest tube duration. Polyglactin mesh should be considered as an alternative option for surgical pleurodesis.