Evaluation and Management of Primary Spontaneous Pneumothorax in Adolescents and Young Adults: A Systematic Review From the APSA Outcomes &amp; Evidence-Based Practice Committee

Speck, K. Elizabeth; Kulaylat, Afif N.; Baerg, Joanne; Acker, Shannon N.; Baird, Robert; Beres, Alana L.; Chang, Henry L.; Derderian, S. Christopher; Englum, Brian R.; Gonzalez, Katherine W.; Kawaguchi, Akemi L.; Kelley-Quon, Lorraine I.; Levene, Tamar; Rentea, Rebecca M.; Rialon, Kristy L.; Ricca, Robert L.; Sømme, Stig; Wakeman, Derek; Yousef, Yasmine; Peter, Shawn D. St.; Lucas, Cmdr. Donald J.

doi:10.1016/j.jpedsurg.2023.03.018

Cited by 3 publications

(2 citation statements)

References 81 publications

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“…The British Thoracic Society and French guidelines recommend that patients with persistent air leakage or pneumothorax after 3–5 days on the chest radiograph should undergo surgery [ 7 , 8 ]. The alternatives of surgical treatments are wedge resection with/without pleurodesis or pleurodesis alone with thoracotomy or VATS [ 9 ]. Pleurodesis options are chemical (i.e., talc powder, doxycycline, and iodine), or mechanical (pleural abrasion and pleurectomy) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The complication rates associated with chest tube placement have been reported to be between 3% and 18% [ 22 ]. Early VATS reduced the total hospital stay, charges, and readmissions compared to initial tube placement and resolution observation [ 9 ]. Early postoperative mobilization decreased air leaks, lung expansion failure, pulmonary infection, and length of hospitalization [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Unaldi

2024

kitp

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Introduction: Although primary spontaneous pneumothorax is a common disease in young adults, each thoracic surgery department performs different procedures for its management. Aim: The optimal time of postoperative mobilization is not yet standardized in lung surgery. Material and methods: This study included male patients with a primary spontaneous pneumothorax who underwent wedge resection of the upper lobe of the lungs via uniportal video-assisted thoracoscopic surgery. Patients were encouraged to stand up within the first postoperative hour. Mobilization was defined as standing and walking at least 100 m from the bed. If orthostatic hypotension occurred, mobilization was postponed for 30 min. Immediately after surgery, intravenous fluids were discontinued, and patients were instructed to drink water. The analgesic treatment needs, length of hospitalization, drainage, and discharge times were recorded. Results: A total of 43 patients were operated on by the same surgeon. All operations were ended with uniportal video-assisted thoracoscopic surgery. Wedge resection is most commonly indicated for recurrent ipsilateral pneumothorax. Patients walked 345 (range: 150-510) m on the department corridor following bed rest. Paracetamol (2 g) and dexketoprofen (100 mg) were intravenously administered as postoperative analgesia to 76.7% of patients. Narcotic drugs were not needed. Conclusions: Mobilization was recommended in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Unaldi

2024

kitp

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The Role of Medical Thoracoscopy with Talc Poudrage in Spontaneous, Iatrogenic, and Traumatic Pneumothorax: A Prolonged Experience of a Tertiary Care Center

Fantin,

Castaldo,

Crisafulli

et al. 2024

Pulm Ther

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Introduction Medical thoracoscopy is a minimally invasive and safe procedure mostly performed for unexplained exudative pleural effusions but may be considered for pneumothorax (PNX). Methods This retrospective study included participants affected by PNX who underwent medical thoracoscopy with talc poudrage at a single academic hospital from 2008 to 2021. The primary endpoint was the observation of complete radiographical lung re-expansion and absence of air supply from the chest drain within 7 days of medical thoracoscopy. The secondary endpoint was achieving no recurrence of ipsilateral PNX at 24 months post-discharge. Results A total of 95 patients affected by primary spontaneous PNX (PSP), secondary spontaneous PNX (SSP), iatrogenic, and traumatic PNX were enrolled. An additional procedure was required by 17.89% of patients, and only one patient with SSP required subsequent surgery. Recurrence of PNX occurred on the same side within 24 months after discharge in 9.47% of patients, with a median time to recurrence of 13.5 months. The PSP group was significantly more likely to achieve the primary endpoint. Pleural morphology was significantly associated with reaching the primary endpoint, while receiving a cumulative dose of talc greater than or equal to 4 g during hospitalization was associated with a lower risk of meeting it. Receiving a cumulative dose of talc greater than or equal to 4 g led in all cases to the achievement of the secondary endpoint. Patients with iatrogenic and traumatic PNX had an excellent prognosis in both the short- and long-term evaluation. Conclusion Medical thoracoscopy is an effective procedure for treating PNX in the acute setting in selected cases while preventing long-term relapses. Large prospective clinical studies are needed to support and better define the role of medical thoracoscopy in current clinical practice. Supplementary Information The online version contains supplementary material available at 10.1007/s41030-024-00268-w.

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Pneumothorax spontané primitif de l’enfant : une mise au point

Vinit,

Poirault,

Lozach

et al. 2024

Journal de Pédiatrie et de Puériculture

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Evaluation and Management of Primary Spontaneous Pneumothorax in Adolescents and Young Adults: A Systematic Review From the APSA Outcomes & Evidence-Based Practice Committee

Cited by 3 publications

References 81 publications

Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

The Role of Medical Thoracoscopy with Talc Poudrage in Spontaneous, Iatrogenic, and Traumatic Pneumothorax: A Prolonged Experience of a Tertiary Care Center

Pneumothorax spontané primitif de l’enfant : une mise au point

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