Outcomes and Trends of Open Thoracotomy and Video-Assisted Thoracic Surgery for Surgical Management of Catamenial Pneumothorax: A 10-Year Retrospective Cohort Study of a Thai Population

Background Catamenial pneumothorax (CP) is characterized by pneumothorax associated with menstrual cycles and thoracic endometriosis. This study aimed to review the outcomes and trends for surgical treatment of CP in King Chulalongkorn Memorial Hospital. Methodology We included females aged 18 to 50 years who underwent surgery for CP between January 2012 and December 2022. A total of 17 patients were identified. A retrospective data collection from each patient was done, including demographic data, surgery type (open vs. video-assisted thoracic surgery (VATS)), pleural procedures, length of stay, and complications. Results The mean age at surgery was 36.29 years (±6.78). The median follow-up period was 36 months (range = 12-122). Pneumothorax occurred predominantly on the right side (94.12%), and pelvic endometriosis was present in all patients. All 17 patients underwent surgery, with open surgery in six and VATS in 11 patients. Diaphragmatic procedures were performed in 15 patients, with pleurectomy in nine, lung resection in 11, and pleurodesis in 10 patients. Pleurectomy was significantly associated with a reduced recurrence rate (p = 0.029). Diaphragmatic lesions were absent in two cases, and four patients experienced recurrence. Conclusions This cohort study of CP in the Thai population demonstrated that pleurectomy is associated with lower recurrence. There was no difference in recurrence between open surgery and VATS. Corresponding to the British Thoracic Society Guideline 2023, pleurectomy may help reduce recurrence.