Management of Primary Spontaneous Pneumothorax: Our Single-center, Five-year Experience

Overview

Journal Turk Gogus Kalp Damar Cerrahisi Derg

Specialty Cardiology & Vascular Diseases

Date 2022 Apr 21

PMID 35444856

Authors

Kerim Tuluce

Hasan Turut

Affiliations

Soon will be listed here.

Abstract

Background: In this study, we aimed to analyze the effects of admission time to the hospital and different variables on the treatment efficiency and to evaluate the recurrence during the clinical management process in patients with the diagnosis of primary spontaneous pneumothorax.

Methods: A total of 149 patients with primary spontaneous pneumothorax (131 males, 18 females; mean age: 24.8±6.8 years; range, 17 to 35 years) treated in our clinic between January 2015 and December 2019 were retrospectively analyzed. Time from symptom onset to hospital admission (admission time) was classified as three periods: <24 h, between 24 and 72 h, and >72 h. Data including admission time, demographic and clinical characteristics, smoking history, body mass index, the use of pleurectomy or pleural abrasion during surgery were collected from the charts of the patients.

Results: Admission time had no statistically significant effect on the length of hospital stay, recurrence, and the need for surgery. Male sex, smoking history, and lower body mass index had no significant effect on the recurrence. Recurrence and length of hospital stay did not significantly differ between the patients in whom pleurectomy or pleural abrasion added to the procedure during the operation.

Conclusion: A longer interval between symptom onset and hospital admission and lower body mass index have no adverse effect on treatment outcomes and the recurrence in patients with primary spontaneous pneumothorax. Despite the fact that surgical treatment significantly decreases the recurrence rate, pleurectomy and pleural abrasion techniques have no significant difference on the clinical influence and recurrence of these patients.

Citing Articles

Pleural abrasion versus apical pleurectomy for primary spontaneous pneumothorax: a systematic review and Meta-analysis.

Chang J, Ratnaraj V, Fu V, Jiang M, Peri V, Nguyenhuy M J Cardiothorac Surg. 2023; 18(1):105.

PMID: 37024894 PMC: 10080866. DOI: 10.1186/s13019-023-02207-3.

References

Bar-El Y, Ross A, Kablawi A, Egenburg S . Potentially dangerous negative intrapleural pressures generated by ordinary pleural drainage systems. Chest. 2001; 119(2):511-4. DOI: 10.1378/chest.119.2.511. View

Noppen M, De Keukeleire T . Pneumothorax. Respiration. 2008; 76(2):121-7. DOI: 10.1159/000135932. View

MacDuff A, Arnold A, Harvey J . Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010; 65 Suppl 2:ii18-31. DOI: 10.1136/thx.2010.136986. View

Vuong N, Elshafay A, Thao L, Abdalla A, Mohyeldin I, Elsabaa K . Efficacy of treatments in primary spontaneous pneumothorax: A systematic review and network meta-analysis of randomized clinical trials. Respir Med. 2018; 137:152-166. DOI: 10.1016/j.rmed.2018.03.009. View

Kutluk A, Kocaturk C, Akin H, Erdogan S, Bilen S, Karapinar K . Which is the Best Minimal Invasive Approach for the Treatment of Spontaneous Pneumothorax? Uniport, Two, or Three Ports: A Prospective Randomized Trail. Thorac Cardiovasc Surg. 2018; 66(7):589-594. DOI: 10.1055/s-0038-1629909. View

Tan J, Yang Y, Zhong J, Zuo C, Tang H, Zhao H . Association Between BMI and Recurrence of Primary Spontaneous Pneumothorax. World J Surg. 2016; 41(5):1274-1280. PMC: 5394140. DOI: 10.1007/s00268-016-3848-8. View

Chambers A, Scarci M . In patients with first-episode primary spontaneous pneumothorax is video-assisted thoracoscopic surgery superior to tube thoracostomy alone in terms of time to resolution of pneumothorax and incidence of recurrence?. Interact Cardiovasc Thorac Surg. 2009; 9(6):1003-8. DOI: 10.1510/icvts.2009.216473. View

Noppen M, Baumann M . Pathogenesis and treatment of primary spontaneous pneumothorax: an overview. Respiration. 2003; 70(4):431-8. DOI: 10.1159/000072911. View

Grundy S, Bentley A, Tschopp J . Primary spontaneous pneumothorax: a diffuse disease of the pleura. Respiration. 2012; 83(3):185-9. DOI: 10.1159/000335993. View

10.

Olesen W, Lindahl-Jacobsen R, Katballe N, Sindby J, Titlestad I, Andersen P . Recurrent Primary Spontaneous Pneumothorax is Common Following Chest Tube and Conservative Treatment. World J Surg. 2016; 40(9):2163-70. DOI: 10.1007/s00268-016-3508-z. View

11.

Chen J, Chan W, Tsai K, Hsu H, Lin C, Yuan A . Simple aspiration and drainage and intrapleural minocycline pleurodesis versus simple aspiration and drainage for the initial treatment of primary spontaneous pneumothorax: an open-label, parallel-group, prospective, randomised, controlled trial. Lancet. 2013; 381(9874):1277-82. DOI: 10.1016/S0140-6736(12)62170-9. View

12.

Tschopp J, Bintcliffe O, Astoul P, Canalis E, Driesen P, Janssen J . ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax. Eur Respir J. 2015; 46(2):321-35. DOI: 10.1183/09031936.00219214. View

13.

Ng C, Maier H, Kocher F, Jud S, Lucciarini P, Ofner D . VATS Partial Pleurectomy Versus VATS Pleural Abrasion: Significant Reduction in Pneumothorax Recurrence Rates After Pleurectomy. World J Surg. 2018; 42(10):3256-3262. PMC: 6132858. DOI: 10.1007/s00268-018-4640-8. View

14.

Luh S . Review: Diagnosis and treatment of primary spontaneous pneumothorax. J Zhejiang Univ Sci B. 2010; 11(10):735-44. PMC: 2950234. DOI: 10.1631/jzus.B1000131. View

15.

Shaikhrezai K, Thompson A, Parkin C, Stamenkovic S, Walker W . Video-assisted thoracoscopic surgery management of spontaneous pneumothorax--long-term results. Eur J Cardiothorac Surg. 2010; 40(1):120-3. DOI: 10.1016/j.ejcts.2010.10.012. View

16.

Morimoto T, Fukui T, Koyama H, Noguchi Y, Shimbo T . Optimal strategy for the first episode of primary spontaneous pneumothorax in young men. A decision analysis. J Gen Intern Med. 2002; 17(3):193-202. PMC: 1495024. DOI: 10.1046/j.1525-1497.2002.10636.x. View

17.

Ouanes-Besbes L, Golli M, Knani J, Dachraoui F, Nciri N, El Atrous S . Prediction of recurrent spontaneous pneumothorax: CT scan findings versus management features. Respir Med. 2006; 101(2):230-6. DOI: 10.1016/j.rmed.2006.05.016. View

18.

Rankinen T, Sarzynski M, Ghosh S, Bouchard C . Are there genetic paths common to obesity, cardiovascular disease outcomes, and cardiovascular risk factors?. Circ Res. 2015; 116(5):909-22. PMC: 4416656. DOI: 10.1161/CIRCRESAHA.116.302888. View

19.

Chang Y, Chen C, Huang S, Chen J . Modified needlescopic video-assisted thoracic surgery for primary spontaneous pneumothorax : the long-term effects of apical pleurectomy versus pleural abrasion. Surg Endosc. 2006; 20(5):757-62. DOI: 10.1007/s00464-005-0275-6. View

20.

Chiu C, Chen T, Wang C, Tsai M, Wong K . Factors associated with proceeding to surgical intervention and recurrence of primary spontaneous pneumothorax in adolescent patients. Eur J Pediatr. 2014; 173(11):1483-90. DOI: 10.1007/s00431-014-2352-0. View