{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:20:49Z","timestamp":1772983249083,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The indications for surgery in primary spontaneous pneumothorax (PSP) at first episode are clearly defined. Despite the indications, some patients avoid surgical treatment. This study examines the factors affecting early recurrence in patients who have not undergone surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective and multicenter study was conducted between January 2018 and June 2023. The impact of demographic characteristics, inflammatory response, smoking habits before and after the episode, treatment modality, duration of chest tube drainage, and quantitative measurements of bullae\u2013bleb structures on the risk and timing of recurrence was examined in 117 cases of first episode PSP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Age, sex, inflammatory response indicators, pre\u2010episode smoking history, pneumothorax volume, and bullae size were not associated with earlier recurrence. The detection of bullae\u2013blebs on computed tomography in first episode PSP and smoking post\u2010episode in non\u2010surgically treated cases were correlated with earlier recurrence (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.031;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.019, respectively). In cases that surgical intervention had not been performed, a prolonged duration of chest tube drainage correlated with increased recurrence\u2010free survival and decreased recurrence risk (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In cases of first episode PSP, surgical intervention may be advised when bullae\u2013bleb formations are detected via tomography. Patients who did not undergo surgical treatment during the first episode and smoke after discharge are at higher risk of earlier recurrence. Prolonged chest tube drainage duration reduces the risk of earlier recurrence in first\u2010episode PSP cases that have not undergone surgical intervention. This finding suggests that extended drainage is not a disadvantageous outcome for cases hesitant to undergo surgical treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70008","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T13:43:13Z","timestamp":1753105393000},"page":"2335-2343","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Early Recurrence in Non\u2010Surgically Managed Primary Spontaneous Pneumothorax"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7952-5891","authenticated-orcid":false,"given":"Sercan","family":"Aydin","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Izmir Democracy University Buca Seyfi Demirsoy Education and Research Hospital  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6162-4878","authenticated-orcid":false,"given":"Seda Kahraman","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Izmir Democracy University Buca Seyfi Demirsoy Education and Research Hospital  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4561-4589","authenticated-orcid":false,"given":"Dilara","family":"Gursoy","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Ege University Faculty of Medicine  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8854-953X","authenticated-orcid":false,"given":"Ayse","family":"Gul Ergonul","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Ege University Faculty of Medicine  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7108-9469","authenticated-orcid":false,"given":"Tevfik","family":"Ilker Akcam","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Ege University Faculty of Medicine  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4150-0514","authenticated-orcid":false,"given":"Kutsal","family":"Turhan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Acibadem Kent Hospital  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7827-793X","authenticated-orcid":false,"given":"Ufuk","family":"Cagirici","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Ege University Faculty of Medicine  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4958-0996","authenticated-orcid":false,"given":"Alpaslan","family":"Cakan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Ege University Faculty of Medicine  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2692-3762","authenticated-orcid":false,"given":"Omer","family":"Faruk Dadas","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics Ege University Faculty of Medicine  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030490"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010016\u20103848\u20108"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00079304"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/cmar.s287897"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.5505\/ejm.2020.71501"},{"key":"e_1_2_9_7_1","article-title":"The Relationship Between Mortality and 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