{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:58:24Z","timestamp":1790639904952,"version":"4.1.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Non-steroidal anti-inflammatory drugs (NSAIDs) are a cornerstone of multimodal postoperative analgesia. However, their use remains controversial in surgery for spontaneous pneumothorax because inflammation plays a key role in the development of pleural symphysis during pleurodesis. This retrospective study aimed to evaluate the impact of postoperative NSAID administration after thoracoscopic surgery for spontaneous pneumothorax on chest drainage duration.<\/jats:p>\n                  <jats:p>We conducted a monocentric retrospective observational study including patients who underwent video-assisted thoracoscopic surgery for spontaneous pneumothorax between January 1, 2015, and December 31, 2020. The primary endpoint was prolonged chest drainage, defined as drainage lasting \u2265\u20093 postoperative days. Secondary endpoints included early markers of pleural symphysis, postoperative analgesia, and postoperative complications.<\/jats:p>\n                  <jats:p>A total of 558 patients were included, of whom 245 (44%) received postoperative NSAIDs and 313 (56%) did not. In multivariable logistic regression, NSAIDs administration was significantly associated with a reduced risk of prolonged chest drainage (OR 0.62; 95%CI: 0.44\u20130.89; p\u2009=\u20090.009). This association remained consistent after propensity score weighting (IPTW OR 0.66; 95%CI: 0.46\u20130.95) and sensitivity analyses. No significant differences were observed between the groups regarding postoperative complications or pleurodesis efficacy. The use of patient-controlled opioid analgesia was significantly lower in the NSAID group (p\u2009&lt;\u20090.001).<\/jats:p>\n                  <jats:p>Postoperative NSAID administration was associated with a reduced incidence of prolonged chest drainage, without evidence of worse early postoperative outcomes. These findings do not support impaired short-term pleural symphysis, although definitive conclusions on long-term pleurodesis efficacy would require prospective studies with extended follow-up.<\/jats:p>","DOI":"10.1055\/a-2965-7880","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:01:15Z","timestamp":1790636475000},"source":"Crossref","is-referenced-by-count":0,"title":["Association Between Postoperative NSAID and Chest Drainage Duration After VATS Pleurodesis"],"prefix":"10.1055","author":[{"given":"Florent","family":"Leviel","sequence":"additional","affiliation":[{"name":"CHU Amiens-Picardie, Hauts-de-France, France","place":["Amiens"],"department":["Department of Anesthesiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1614-7759","authenticated-orcid":false,"given":"Paul","family":"Tarpin","sequence":"additional","affiliation":[{"name":"CHU Amiens-Picardie, Hauts-de-France, France","place":["Amiens"],"department":["Department of Anesthesiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"De Dominicis","sequence":"additional","affiliation":[{"name":"CHU Amiens-Picardie, Hauts-de-France, France","place":["Amiens"],"department":["Department of Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoni","family":"Merlusca","sequence":"additional","affiliation":[{"name":"CHU Amiens-Picardie, Hauts-de-France, France","place":["Amiens"],"department":["Department of Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Witte Pfizer","sequence":"additional","affiliation":[{"name":"CHU Amiens-Picardie, Hauts-de-France, France","place":["Amiens"],"department":["Department of Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Epailly","sequence":"additional","affiliation":[{"name":"CHU Amiens-Picardie, Hauts-de-France, France","place":["Amiens"],"department":["Department of Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Georges","sequence":"additional","affiliation":[{"name":"CHU Amiens-Picardie, Hauts-de-France, France","place":["Amiens"],"department":["Department of Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Abou-Arab","sequence":"additional","affiliation":[{"name":"CHU Amiens-Picardie, Hauts-de-France, France","place":["Amiens"],"department":["Department of Anesthesiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"14","key":"ref1","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1001\/jama.2018.14299","article-title":"Trends in the incidence and recurrence of inpatient-treated spontaneous pneumothorax, 1968-2016","volume":"320","author":"R J Hallifax","year":"2018","journal-title":"JAMA"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1136\/thoraxjnl-2014-206577","article-title":"Epidemiology of spontaneous pneumothorax: gender-related differences","volume":"70","author":"A Bobbio","year":"2015","journal-title":"Thorax"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.annemergmed.2013.12.017","article-title":"Ambulatory management of large spontaneous pneumothorax with pigtail catheters","volume":"64","author":"F Voisin","year":"2014","journal-title":"Ann Emerg Med"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1093\/icvts\/ivz290","article-title":"Epidemiology and management of primary spontaneous pneumothorax: a systematic review","volume":"30","author":"P Mendogni","year":"2020","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1159\/000490179","article-title":"Management of spontaneous pneumothorax and post-interventional pneumothorax: German S3 guideline","volume":"97","author":"J Schnell","year":"2019","journal-title":"Respiration"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1183\/09031936.00219214","article-title":"ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax","volume":"46","author":"J M Tschopp","year":"2015","journal-title":"Eur Respir J"},{"issue":"01","key":"ref7","first-page":"3","article-title":"SECT clinical practice guideline on the management of patients with spontaneous pneumothorax","volume":"96","author":"B Aguinagalde","year":"2018","journal-title":"Cir Esp (Engl Ed)"},{"issue":"S 02","key":"ref8","first-page":"ii18","article-title":"Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010","volume":"65","author":"A MacDuff","year":"2010","journal-title":"Thorax"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/ALN.0b013e31828866b3","article-title":"Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures","volume":"118","author":"H J Gerbershagen","year":"2013","journal-title":"Anesthesiology"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1093\/bja\/aew391","article-title":"Non-opioid analgesics in adults after major surgery: systematic review with network meta-analysis of randomized trials","volume":"118","author":"V Martinez","year":"2017","journal-title":"Br J Anaesth"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1159\/000341670","article-title":"Perioperative diclofenac application during video-assisted thoracic surgery pleurodesis modulates early inflammatory and fibrinolytic processes in an experimental model","volume":"50","author":"I Opitz","year":"2013","journal-title":"Eur Surg Res"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/j.ejcts.2004.01.028","article-title":"Non-steroidal anti-inflammatory drugs decrease the quality of pleurodesis after mechanical pleural abrasion","volume":"25","author":"D Lardinois","year":"2004","journal-title":"Eur J Cardiothorac Surg"},{"issue":"01","key":"ref13","first-page":"100791","article-title":"Guidelines on enhanced recovery after pulmonary lobectomy","volume":"40","author":"P Berna","year":"2021","journal-title":"Anaesth Crit Care Pain Med"},{"issue":"11","key":"ref14","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1007\/s00268-011-1207-3","article-title":"Nonsteroidal antiinflammatory medications: efficient and safe treatment following video-assisted pleurodesis for spontaneous pneumothorax","volume":"35","author":"A Ben-Nun","year":"2011","journal-title":"World J Surg"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.jpedsurg.2017.06.010","article-title":"The use of perioperative ketorolac in the surgical treatment of pediatric spontaneous pneumothorax","volume":"53","author":"R M Dorman","year":"2018","journal-title":"J Pediatr Surg"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.hlc.2023.12.018","article-title":"Prolonged non-steroidal anti-inflammatory drug exposure after pleurodesis increases pneumothorax recurrence: a retrospective cohort study","volume":"33","author":"J DL Brookes","year":"2024","journal-title":"Heart Lung Circ"},{"issue":"24","key":"ref17","doi-asserted-by":"crossref","first-page":"2641","DOI":"10.1001\/jama.2015.16840","article-title":"Effect of opioids vs NSAIDs and larger vs smaller chest tube size on pain control and pleurodesis efficacy among patients with malignant pleural effusion: the TIME1 randomized clinical trial","volume":"314","author":"N M Rahman","year":"2015","journal-title":"JAMA"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s12013-014-0482-7","article-title":"Effects of flurbiprofen axetil on postoperative analgesia and cytokines in peripheral blood of thoracotomy patients","volume":"72","author":"M Zhou","year":"2015","journal-title":"Cell Biochem Biophys"},{"issue":"07","key":"ref19","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1001\/jamasurg.2017.0898","article-title":"Postoperative multimodal analgesia pain management with nonopioid analgesics and techniques: a review","volume":"152","author":"E C Wick","year":"2017","journal-title":"JAMA Surg"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"R43","DOI":"10.1186\/cc7766","article-title":"A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock","volume":"13","author":"A Legras","year":"2009","journal-title":"Crit Care"},{"issue":"05","key":"ref21","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.jamcollsurg.2021.01.005","article-title":"Systematic review and meta-analysis of the association between non-steroidal anti-inflammatory drugs and operative bleeding in the perioperative period","volume":"232","author":"T Bongiovanni","year":"2021","journal-title":"J Am Coll Surg"},{"issue":"03","key":"ref22","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/j.athoracsur.2013.10.031","article-title":"Risk factors predisposing to prolonged air leak after video-assisted thoracoscopic surgery for spontaneous pneumothorax","volume":"97","author":"L Jiang","year":"2014","journal-title":"Ann Thorac Surg"},{"issue":"01","key":"ref23","first-page":"259","article-title":"Factors influencing the duration of chest tube drainage in patients hospitalized for pneumothorax","volume":"14","author":"E Ben Jemia","year":"2022","journal-title":"Review of Respiratory Diseases News"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2965-7880.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:01:18Z","timestamp":1790636478000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2965-7880"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":23,"URL":"https:\/\/doi.org\/10.1055\/a-2965-7880","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}