ArticleJournal of cardiothoracic surgery2026
Residual apical space (RAS) correlation with recurrence in primary spontaneous pneumothorax after surgery: multicenter analysis stratified by type of surgery.
Article in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study aims to evaluate residual apical space (RAS) as a predictor of pneumothorax recurrence in patients undergoing video-assisted thoracoscopic surgery (VATS) for primary spontaneous pneumothorax (PSP) and to assess its impact by surgical treatment type.
methodsData of 463 patients undergoing VATS for PSP at three Italian high-volume thoracic surgery centers (January 2012-March 2023) were retrospectively reviewed. Exclusions included secondary pneumothorax, patients < 18 years, and those undergoing thoracotomy. Four surgical approaches were analyzed, with RAS measured using the Collins method (4.2% equivalent to 0 cm RAS) on chest X-ray before discharge. The primary outcome of interest was the recurrence rate stratified by surgical procedure. Statistical analyses were performed to correlate RAS, clinical and surgical variables with pneumothorax recurrence.
resultsThe overall recurrence rate was 6.9% (32 patients). The mean hospitalization was 6.5 ± 3.5 days, with an average RAS before discharge of 9.7 ± 5.4%=1.15 cm. Mechanical pleurodesis alone had an higher recurrence risk (*p* = 0.0027), while apicectomy with chemical pleurodesis significantly reduced recurrence risk (*p* < 0.0001). Increased RAS (> 9.7%) was associated with a higher recurrence rate (*p* = 0.063). Multivariate analysis confirmed that increased RAS significantly predicts recurrence (*p* = 0.002), particularly in patients aged > 34 years. Stratifying by type of surgery, an increased RAS value was associated to higher rate of recurrence (*p* = 0.001) in patients who underwent apicectomy combined to mechanical pleurodesis.
conclusionsApicectomy combined with chemical pleurodesis is still the most protective approach for recurrence. However, despite its proven efficacy, this strategy is being progressively used less. Residual apical space may represent a procedure-dependent radiological marker associated with recurrence, particularly in patients undergoing apicectomy and mechanical pleurodesis and may be considered to reduce recurrence rates.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.