How to treat recurrent pneumothorax for the second time?

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on December 13, 2024
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Patients with recurrent pneumothorax, we recommend proactive minimally invasive surgical intervention. For patients experiencing their first recurrence of pneumothorax, the likelihood of a second recurrence is about 20-30%. For those who have had two episodes of pneumothorax, it indicates the presence of a small rupture on the lung, or an area that has not healed well, or is particularly weak. Thus, for patients who have had two episodes or a second occurrence of pneumothorax, if they do not receive active treatment, the probability of a third recurrence rises to about 70-80%. Whether using minimally invasive surgery or the conservative method of simple tube insertion, both are certainly burdensome for the patient. However, for patients with a second occurrence of pneumothorax, undergoing a small minimally invasive surgery, which involves a small incision of one to two centimeters under the armpit to treat the pneumothorax, dramatically reduces the likelihood of subsequent occurrences from the previous 70-80% to below 10%. Therefore, the best treatment for a second pneumothorax episode is through minimally invasive surgical intervention.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pneumothorax recurrence symptoms

We know that normally there is no air in the pleural cavity, only a small amount of fluid or lubricant exists. However, in certain people, such as those who often smoke, tall and thin young people, and patients with chronic bronchitis, the alveoli in their lungs tend to be more fragile and can easily rupture. People experiencing a pneumothorax for the first time might feel this during certain situations like after a cold, coughing, sneezing, or playing sports, which can lead to a recurrence of the pneumothorax. Early symptoms of a recurrence, due to only a small amount of air compression, might not be very uncomfortable, just a slight sense of difficulty breathing. As the pneumothorax increases, symptoms like chest pain and difficulty breathing can develop. Therefore, the symptoms of a recurring pneumothorax are not identical each time, but there is a pattern; the severity can range from mild breathing difficulty to severe respiratory distress and chest pain.

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Written by Wang Xiang Yu
Pulmonology
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What department should I go to for pneumothorax?

What department is pneumothorax treated in? For pneumothorax, we commonly see patients first in the emergency department, as the onset of pneumothorax is generally very sudden and the condition can be quite severe. The patient may suddenly experience difficulty breathing, and in most cases, this breathing difficulty is severe. Therefore, patients typically start by seeing the emergency internal medicine department. The doctors there will assess the patient’s condition and will consult with thoracic and cardiovascular surgery and respiratory medicine. If a closed thoracic drainage tube is needed, our surgeons will immediately perform the drainage. If the patient can be treated conservatively, they are usually then transferred to either respiratory medicine or thoracic and cardiovascular surgery for further treatment.

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Written by Han Shun Li
Pulmonology
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Can you smoke with pneumothorax?

After suffering from pneumothorax, patients often experience symptoms such as chest pain, chest tightness, and coughing. Can patients smoke after suffering from pneumothorax? It is advised against smoking after suffering from pneumothorax, as smoke and harmful substances directly irritate the respiratory tract, worsening the patient's symptoms. Additionally, smoking produces a large amount of carbon monoxide, which, when absorbed by the body, can cause hypoxia, thereby exacerbating symptoms of breathing difficulty. Therefore, patients with pneumothorax should not smoke, and it is also recommended to quit smoking even after recovery from pneumothorax, as smoking is harmful in many ways and particularly damaging to the respiratory system.

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Written by Han Shun Li
Pulmonology
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Can pneumothorax heal by itself?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural cavity, and it is relatively common clinically. Can pneumothorax be cured after it occurs? It depends on the specific circumstances. If it is a closed pneumothorax with a small amount of air accumulation, conservative treatments like rest and oxygen therapy can allow for self-healing of the pneumothorax. However, in most cases, the accumulation of air is generally significant, and often it is a tension pneumothorax. In these instances, treatments generally involve pleural cavity puncture, or closed pleural drainage to drain the air, making it difficult to heal spontaneously and requiring medical treatment. Moreover, some patients may not recover fully despite aggressive treatment and may require surgical intervention.

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Written by Han Shun Li
Pulmonology
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Can pneumothorax recover by itself?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural space. Patients often display symptoms such as coughing, chest pain, chest tightness, and shortness of breath. A lung radiograph can confirm the presence of a pneumothorax. Whether a patient with pneumothorax can recover on their own depends on the size of the pneumothorax. If it is a large pneumothorax, especially a communicative or tension pneumothorax, self-recovery is not possible, and treatment generally involves pleural puncture or pleural drainage tube placement. However, if the amount of air in the pneumothorax is small and the patient does not exhibit severe symptoms, then it is possible for the condition to resolve itself with bed rest.