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Regular Article| Volume 95, ISSUE 11, P857-862, November 2001

Spontaneous pneumothorax : pragmatic management and long-term outcome

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      Abstract

      We prospectively considered 65 patients admitted for a spontaneous pneumothorax (SP) to describe the pragmatic management of SP, the first recurrence-free interval after medical therapeutic procedure and to specify the first recurrence risk factors over a 7-year period in these patients treated medically.
      The treatment options were observation alone (9%), needle aspiration (6%), small calibre chest tube (Pleuro-catheter®) drainage (28%) or thoracic tube drainage (49%), and pleurodesis with video-assisted thoracic surgery procedure (8%). Duration of the drainage and length of hospital stay were shorter in the Pleurocatheter®group than in the thoracic tube group (P<0·01). Among the 47 patients (72%) with a first SP and treated medically, nine patients (19%) had a first homolateral recurrence (FHR) during a mean follow-up of 84±13 months. Recurrence-free intervals ranged from 1 to 24 months (mean±Math Eq: 9·3±8·4 months). FHR cases were more frequent in the Pleurocatheter®group (P<0·04).
      Analysis of potential risk factors showed that the patient's height and a previous homolateral SP episode are independent recurrence risk factors.

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      References

      REFERENCES

        • Guerin JC
        • Bayle JY
        • Perol M
        Spontaneous pneumothoryax editions techniques.
        Encycl Méd Chir (Paris-France) Pneumologie. 1994; 6-045-A10: 1-9
        • Lichter I
        Long term follow up of planned treatment of spontaneous pneumothorax.
        Thorax. 1974; 29: 32-37
      1. BMJ. 1993; 307: 114-116
        • Lippert HL
        • Lund O
        • Blegvad S
        • Larsen HV
        Independant risk factors for cumulative recurrence rate after first spontaneous pneumothorax.
        Eur Respir J. 1991; 4: 324-331
        • Elfeldt RJ
        • Schröder DW
        • Thies J
        Long-term follow-up of different therapy procedures in spontaneous pneumothorax.
        J Cardiovasc Surg. 1994; 35: 229-233
        • Sadikot RT
        • Greene T
        • Meadows K
        • Arnold AG
        Recurrence of primary spontaneous pneumothorax.
        Thorax. 1997; 52: 805-809
        • Warner BW
        • Bayley WW
        • Shipley RT
        Value of computed tomography of the lung in the management of primary spontaneous pneumothorax.
        Am J Surg. 1991; 162: 39-42
        • O'rourke JP
        • Yee ES
        Civilian pneumothorax: treatment options and long term results.
        Chest. 1989; 96: 1302-1306
      2. Thorax. 1993; 48: 430-431
        • Andrivet P
        • Djedini K
        • Teboul JL
        • Brochard L
        • Dreyfuss D
        Spontaneous pneumothorax: comparison of thoracic drainage vs. immediate or delayed needle aspiration.
        Chest. 1995; 108: 335-340
        • Conces DJ
        • Tarver RD
        • Gray WC
        • Pearcy EA
        Treatment of pneumothoraces utilizing small caliber chest tubes.
        Chest. 1988; 94: 55-57
        • Martin T
        • Fontana G
        • Olak J
        • Ferguson M
        Use of a pleural catheter for the management of simple pneumothorax.
        Chest. 1996; 110: 1169-1172
        • Minami H
        • Saka H
        • Senda K
        • Horio Y
        • Iwahara T
        • Nomura F
        • Sakai S
        • Shimokata K
        Small caliber catheter drainage for spontaneous pneumothorax.
        Am J Med Sci. 1992; 304: 345-347
        • Light RW
        Management of spontaneous pneumothorax.
        Am Rev Respir Dis. 1993; 148: 245-248
        • Boutin C
        • Viallat JR
        Pathologie pleurale.
        in: Aubier M Fournier M Pariente R Pneumologie. Médecine-Sciences Flammarion, Paris1996: 443-473
        • Chee CB
        • Abisheganaden J
        • Yeo JK
        Persistent air-leak in spontaneous pneumothorax—clinical course and outcome.
        Respir Med. 1998; 92: 757-761
        • Senac JP
        • Giron J
        • Aguado JL
        Value of computed tomograaphy for pretherapeutic evaluation of adults with spontaneous idiopathic pneumothorax. Report of twenty-five cases.
        Ann Radiol. 1985; 28: 586-591