Size of Pneumothorax can be a New Indication for Surgical Treatment in Primary Spontaneous Pneumothorax: A Prospective Study

Sayar, Adnan; Kök, Abdülaziz; Çıtak, Necati; Metin, Muzaffer; Büyükkale, Songül; Gürses, Atilla

doi:10.5761/atcs.oa.12.02212

Cited by 29 publications

(24 citation statements)

References 16 publications

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“…Radiological changes like a large pneumothorax/total atelectasis and pronounced bullous changes in PSP offer good support making the indication for surgery [10,89,90,95,136,137]. The CT can be helpful in estimating the risk of recurrence.…”

Section: Operation Of the Pspmentioning

confidence: 99%

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Management of Spontaneous Pneumothorax and Post-Interventional Pneumothorax: German S3 Guideline

et al. 2018

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In Germany, 10,000 cases of spontaneous pneumothorax are treated inpatient every year. The German Society for Thoracic Surgery, in co-operation with the German Society for Pulmonology, the German Radiological Society, and the German Society of Internal Medicine has developed an S3 guideline on spontaneous pneumothorax and post-interventional pneumothorax moderated by the German Association of Scientific Medical Societies. Method: Based on the source guideline of the British Thoracic Society (2010) for spontaneous pneumothorax, a literature search on spontaneous pneumothorax was carried out from 2008 onwards, for post-interventional pneumothorax from 1960 onwards. Evidence levels according to the Oxford Center for Evidence-Based Medicine (2011) were assigned to the relevant studies found. Recommendations according to grade (A: “we recommend”/“we do not recommend,” B: “we suggest”/“we do not suggest”) were determined in 3 consensus conferences by the nominal group process. Results: The algorithms for primary and secondary pneumothorax differ in the indication for CT scan as well as in the indication for chest drainage application and video-assisted thoracic surgery. Indication for surgery is recommended individually taking into account the risk of recurrence, life circumstances, patient preferences, and procedure risks. For some forms of secondary pneumothorax, a reserved indication for surgery is recommended. Therapy of post-interventional spontaneous pneumothorax is similar to that of primary spontaneous pneumothorax. Discussion: The recommendations of the S3 Guideline provide assistance in managing spontaneous pneumothorax and post-interventional pneumothorax. Whether this will affect existing deviant diagnostic and therapeutic measures will be demonstrated by future epidemiological studies.

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Section: Operation Of the Pspmentioning

confidence: 99%

“…The size should therefore be determined and used for the primary assessment of the pneumothorax [89,90].…”

Section: Evidence Grade Ecmentioning

confidence: 99%

Management of Spontaneous Pneumothorax and Post-Interventional Pneumothorax: German S3 Guideline

et al. 2018

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“…With a proper chest tube drainage, the lung expands rapidly and the air-leak usually stops in 48 hours. However, prolonged air-leak after chest tube drainage is possible and sometimes leads to surgery [23][24][25]. In a study by Sayar et al prolonged airleak was observed in 15% of patients and all of them were operated on [23].…”

Section: Discussionmentioning

confidence: 99%

“…However, prolonged air-leak after chest tube drainage is possible and sometimes leads to surgery [23][24][25]. In a study by Sayar et al prolonged airleak was observed in 15% of patients and all of them were operated on [23]. Chee et al reported prolonged air-leak in 25% of PSP patients [25].…”

Section: Discussionmentioning

confidence: 99%

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Does the Chest Tube Removal Time Influence the Outcomes of Primary Spontaneus Pneumothorax First Episode Management?

Mongirdas

Untanas

Jagelavičius

et al. 2019

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Background / objectives. The main treatment option for the first episode of primary spontaneous pneumothorax is chest tube drainage, however, whether delayed chest tube removal might influence the recurrence is unclear.Methods. A prospective study, which included 50 patients, with an initial episode of primary spontaneous pneumothorax was performed. Patients were randomized into two groups according to the chest tube removal time: 1-day and 5-days after the air-leak has stopped. All patients were followed-up for at least six months. Both groups were compared according to the recurrence rate and possible complications.Results. There were 39 (78%) men and the median age was 27 (23–35) years. Successful management with a chest tube was achieved in 43 (86%) patients, others were operated on because of the continuous air-leak or relapse of the pneumothorax after the chest tube was removed. Significant difference was not found comparing groups by age, gender, side, tobacco smoking, alpha-1-antitrypsin level, rate of prolonged air-leak, necessity of surgery, and the mean follow-up time. There was a significant difference between groups in hospitalization time: 1-day group – 6 (4–12), 5-days group – 8 (7–10) days, p = 0.017. Five (20%) patients from 1-day group and 3 (12%) from 5-days group had a recurrence, however the difference was not significant (p = 0.702). There were no significant differences comparing groups by the recurrence time or complications.Conclusions. The recurrence rate of primary spontaneous pneumothorax was higher if the chest tube was removed earlier, however not significantly. More data and longer follow-up are necessary to confirm these findings.

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Pneumothorax

Schnell

2023

Springer Reference Medizin

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Size of Pneumothorax can be a New Indication for Surgical Treatment in Primary Spontaneous Pneumothorax: A Prospective Study

Cited by 29 publications

References 16 publications

Management of Spontaneous Pneumothorax and Post-Interventional Pneumothorax: German S3 Guideline

Management of Spontaneous Pneumothorax and Post-Interventional Pneumothorax: German S3 Guideline

Does the Chest Tube Removal Time Influence the Outcomes of Primary Spontaneus Pneumothorax First Episode Management?

Pneumothorax

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