Materials and Methods: Patients who were operated due to PSP in our department between January 2011 and December 2016 were analysed retrospectively. Differences in age, sex, operation side, number of chest tubes inserted during operation, duration of postoperative drainage, need for Heimlich valve system, smoking habit and recurrence were examined between two groups of patients, who underwent axillary thoracotomy and VATS.

Results: Among 180 patients operated during this period, 98 (54.4%) patients underwent VATS, and 82 (45.6%) patients underwent axillary thoracotomy. The recurrence rate was 6.1% (n=6) in VATS patients, while it was 8.5% (n=7) after axillary thoracotomy, and the difference was not statistically significant (p=0.533). Eight of 13 patients with recurrences were found to be active smokers in the postoperative period. It was found that active smoking increased the incidence of recurrences from 3.6% to 19%, and the difference was statistically significant (p=0.001).

Conclusions: We conclude that patients diagnosed with PSP can be operated by videothoracoscopy since there was no significant difference in the recurrence rates after VATS and axillary thoracotomy, and VATS is a more minimally invasive surgical intervention and causes less incision scar compared to axillary thoracotomy. Because of the significant increase in the postoperative recurrence rates, smoking cessation should be recommended to the patients with PSP and necessary precautions should be taken for this purpose. Keywords : primary spontaneous pneumothorax, VATS, axillary thoracotomy, recurrence