Recent research of pathogenesis and causes of recurrence of primary spontaneous pneumothorax

Primary spontaneous pneumothorax(PSP) is common acute disease. Classical symptoms are chest pain,chest distress and dyspnea. An asymptomatic patient with a minimal or small pneumothorax is treated with supplemental oxygen,conservative treatment. Moderate to large pneumothorax are treated by chest tube drainage.Surgery represents the most effective method. Video-assisted thoracoscopic surgery(VATS)is now regarded as the gold standard for the surgical management of PSP. Pathogenesis of PSP has not yet been well elucidated. Most PSP result from spontaneous rupture of a sub-pleural bleb or bulla,which leaks air into the pleural cavity. There are some mechanisms for bleb or bulla formation,nonspecific inflammation,pleural cavity pressure in a tall individual and congenital cause. Flat chest is considered as the risk factor for PSP in adolescent. Smoking is closely related to PSP,and increases the risk of pneumothorax,but smoking is not the determinant. Recurrence is a common and serious problem of PSP,and the recurrence rate has been variably reported as 20%- 60%,and it is related to hypotrophy and the size of pneumothorax. Causes of postoperative recurrence include patient’s cause and operative cause