Management of primary spontaneous pneumothorax: A single-center experience

Abstract

Background:The prevalence of primary spontaneous pneumothorax is high in the Arab region. There is a lack of studies from the Eastern Province of Saudi Arabia highlighting the associated risk factors and demonstrating the effectiveness of surgical management.Objectives:To identify risk factors associated with primary spontaneous pneumothorax and to correlate the effectiveness of surgical management with the rate of disease recurrence.Subjects and Methods:This retrospective chart review included adult patients who presented with primary spontaneous pneumothorax and were managed at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, from January 1, 2005, to December 31, 2014. The results are presented as arithmetic mean for quantitative data, and chi-square test was used for statistical analysis. P ≤0.05 was considered statistically significant.Results:In total, 151 patients with primary spontaneous pneumothorax were included, with the majority being male (98.7%) and Saudis (88.7%). The mean age was 24 ± 6 years (range: 13–49 years), mean height 171 ± 8 cm (range: 144–193 cm) and mean body mass index 19.2 ± 3.8 kg/m2 (range: 13.3–39.0 kg/m2). About 62% of the patients were smokers. Ten patients had an ipsilateral recurrence of primary spontaneous pneumothorax after the first episode was successfully managed. Surgical exploration after the first episode itself was found to significantly reduce the recurrence rate. The study found that in the management of these patients, there was a shift from conventional open thoracotomy to the minimally invasive video-assisted thoracoscopic surgery method.Conclusions:The risk factors for primary spontaneous pneumothorax in this study were consistent with the current literature. Surgical exploration after the first episode of primary spontaneous pneumothorax significantly reduces the recurrence rate and there is a paradigm shift toward a less invasive surgical approach in managing these patients.

Socioeconomic Impact of Recurrent Primary Spontaneous Pneumothorax: Should Video-Assisted Thoracoscopic Surgery Be Considered at First Episode of Primary Spontaneous Pneumothorax?

“…According to the current guidelines [ 1 , 4 , 5 , 6 ], VATS should be considered at recurrence or in case of persistent air leak after CT treatment. Similar to our results, various studies have proven VATS to be superior to CT treatment in terms of recurrence rates, even at first episode of PSP [ 12 , 13 , 14 ]. VATS has also been reported to be associated with shorter hospitalization rates and better quality of life [ 10 , 11 , 12 , 13 , 16 ].…”

“…In cases with ipsilateral or contralateral recurrence of PSP and for those with persistent air leak following chest tube (CT) treatment, the guidelines [ 1 , 4 , 5 , 6 ] recommend video-assisted thoracoscopic surgery (VATS). In various studies, VATS bullectomy with or without pleurectomy was associated with very low rates of recurrence and a short length of hospitalization, even at first episode of PSP [ 10 , 11 , 12 , 13 , 14 ]. Therefore, we wondered if preventive surgical intervention might be a suitable alternative to reduce the recurrence rates and associated economic burden, as well as to mitigate the negative psychological impact that results from anxiety about a potential recurrence [ 15 ].…”

The incidence and predictors of pneumothorax among trauma patients in Saudi Arabia

“…A few studies have investigated non-trauma etiologies of pneumothorax in SA. For instance, a study in the Eastern region of the country 12 found that risk factors for primary spontaneous pneumothorax include being male and a smoker; these risk factors are consistent with current literature.…”

CYTOTOXICITY OF RED ONION EXTRACTS (Allium cepa) AND QUERCETIN FLAVONOID IN TUMOR HEp-2 CELL

“…A bleb é formada em decorrência da rotura de um alvéolo. Com a rotura, o ar alveolar se desloca Já o pneumotórax em sua forma adquirida corresponde ao acúmulo de ar devido a ocorrência de um evento iatrogênico associado aos cuidados de saúde -como punção venosa central, drenagem torácica inadequada, biópsia transtorácica e toracocentese -ao barotrauma ou em decorrência de trauma torácico, seja ele fechado ou penetrante (RODRIGUES, 2019).após o primeiro episódio de pneumotórax espontâneo primário (PSP), em especial em casos com a presença de pneumotórax de grande porte ou um vazamento de ar persistente(ALJEHANI, 2018).Ainda em relação às complicações, os pacientes com trauma torácico podem ter uma morte tardia devido às complicações pleuropulmonares de natureza infecciosa.até sendo superior à radiografia de tórax (RX) em pneumotórax mínimos e localizados. (WONGWAISAYWAN, 2016).…”