{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:58:19Z","timestamp":1790873899942,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Catamenial pneumothorax is an underdiagnosed condition, despite accounting for up to 35% of spontaneous pneumothoraces in young women. This study aims to delineate the most appropriate surgical treatment comparing a 15-year experience of five European centres.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A European multicentre retrospective cohort study was conducted. We evaluated all the spontaneous pneumothoraces occurring in women of childbearing age. We included all the cases with evidence of diaphragmatic alterations. Thirty-six patients were included and evaluated. We compared their surgical treatment, in-hospital variables and rate of recurrence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The surgical approach was thoracoscopic for 34 patients and open for 2. Thirty patients presented diaphragmatic involvement. According to the diaphragmatic treatment the patients were divided into three groups: prosthetic replacement (19; 15 synthetic grafts and 5 biological); surgical repair (6; 4 direct sutures and 2 stapling); and no treatment (11). All patients received pleurodesis (6 mechanical, 15 chemical and 3 a combination of these). Median follow-up was 54\u2009months, during which 15 recurrences occurred. Despite no statistically significant difference between the treatment groups, the relapse rate slightly favoured the prosthetic group (26.3% vs 56.8%, P\u2009=\u20090.09) and direct diaphragmatic repair had a significantly higher conversion rate compared with prosthetic replacement (21% vs 100%, P\u2009=\u20090.004). Notably, none of the patients with biological mesh relapsed during the follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our data suggest treating all diaphragmatic defects with thorough attention. Moreover, prosthetic replacement resulted in a safe and effective procedure and biological mesh should be preferred in this setting, showing excellent postoperative and long-term results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CLINICAL REGISTRATION NUMBER<\/jats:title>\n                  <jats:p>Our institutional review board granted approval and waived the requirement for specific informed consent for this retrospective analysis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaf129","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T12:41:32Z","timestamp":1751373692000},"source":"Crossref","is-referenced-by-count":4,"title":["Surgical management and outcomes of catamenial pneumothorax: a European multicentre real-life comparative study"],"prefix":"10.1093","volume":"40","author":[{"given":"Lavinia","family":"Gatteschi","sequence":"first","affiliation":[{"name":"Thoracic Surgery Unit, Careggi University Hospital , Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Viggiano","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Careggi University Hospital , Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Indino","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Careggi University Hospital , Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Socci","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield,","place":["UK"]},{"name":"Department of Thoracic Surgery, University Hospitals Bristol and Weston NHS Foundation Trust , Bristol,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9909-6820","authenticated-orcid":false,"given":"Marco","family":"Lucchi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac-Thoracic and Vascular Department, University Hospital of Pisa , Pisa,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giovanna","family":"Mastromarino","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac-Thoracic and Vascular Department, University Hospital of Pisa , Pisa,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo F","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Service of Thoracic Surgery, Salamanca University Hospital , Salamanca,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Fuentes-Gago","sequence":"additional","affiliation":[{"name":"Service of Thoracic Surgery, Salamanca University Hospital , Salamanca,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Marulli","sequence":"additional","affiliation":[{"name":"Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari \u201cAldo Moro\u201d , Bari,","place":["Italy"]},{"name":"Department of Biomedical Sciences, Thoracic Surgery, Humanitas University, IRCCS Humanitas Research Hospital , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosatea","family":"Quercia","sequence":"additional","affiliation":[{"name":"Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari \u201cAldo Moro\u201d , Bari,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2818-859X","authenticated-orcid":false,"given":"Luca","family":"Voltolini","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Careggi University Hospital , Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Gonfiotti","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Careggi University Hospital , Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"2025070907500450800_ivaf129-B1","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.athoracsur.2005.07.044","article-title":"Thoracic endometriosis: current knowledge","volume":"81","author":"Alifano","year":"2006","journal-title":"Ann Thorac 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