Nickan Research Institute Immunopathologia Persa 2423-8015 13 1 2027 01 01 Evaluation and comparison of the outcomes of pleural mechanical abrasion and chemical pleurodesis in patients with spontaneous pneumothorax; a retrospective case-control study e44073 e44073 10.34172/ipp.44073 EN Mohammad Talebpour https://orcid.org/0000-0003-1678-4463 Khosrow Najjari https://orcid.org/0000-0001-8795-0401 Hossein Zabihi-Mahmoudabadi https://orcid.org/0000-0002-9092-5124 Asadollah Ekramifar https://orcid.org/0009-0002-9285-6107 Niki Sadat Mosallaei https://orcid.org/0009-0009-8828-8996 Arian Ghannadi Karimi https://orcid.org/0000-0002-5241-4905 Mojtaba Ahmadinejad https://orcid.org/0009-0008-0103-6490 Ehsan Beigi Shahrbabak https://orcid.org/0009-0009-0244-3298 Journal Article 10.34172/ipp.44073 2026 07 04 2026 09 06 Introduction: Spontaneous pneumothorax is a common thoracic emergency, and surgical intervention is often required to prevent recurrence in patients at high risk or with persistent air leak. Among the available surgical strategies, pleural mechanical abrasion and chemical pleurodesis are widely used to achieve pleural symphysis, yet their relative efficacy, safety, and procedural efficiency remain a matter of clinical debate. Objectives: This retrospective case–control study was conducted to evaluate and compare the outcomes of pleural mechanical abrasion and chemical pleurodesis in patients with spontaneous pneumothorax. Patients and Methods: This retrospective case–control study included 82 patients with spontaneous pneumothorax treated at two tertiary hospitals in Karaj, Iran, between March 2019 and March 2022. Patients were allocated to pleural mechanical abrasion (n = 40) or chemical pleurodesis (n = 42) with tetracycline powder, and data on demographics, surgical indications, perioperative variables, postoperative complications, recurrence, and mortality were extracted from medical records and compared between groups. Results: The results indicated that postoperative complications, including pain, fever, hypotension, tachypnea, pneumonia, wound infection, and persistent air leak, and mortality rate did not differ significantly between groups of pleural mechanical abrasion and those receiving chemical pleurodesis (P<0.05). However, pneumothorax recurrence was significantly lower after chemical pleurodesis compared to mechanical abrasion, and chemical pleurodesis was also associated with a significantly shorter operative time (P<0.05). Hospitalization time tended to be shorter with chemical pleurodesis; however, this difference did not reach statistical significance. Conclusion: Chemical pleurodesis with tetracycline powder appears to provide superior clinical efficacy to pleural mechanical abrasion for spontaneous pneumothorax, by reducing recurrence and operative time while maintaining a similar safety profile. These results support chemical pleurodesis as a preferable surgical option in appropriately selected patients.