Routine smoking cessation is advised. More prospective
data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP,
treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of
air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc
poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is available. Video-assisted thoracic
surgery is preferred to thoracotomy as a surgical approach