Management of Spontaneous Pneumothorax and Postinterventional Pneumothorax: German S3-Guideline*

Jost Schnell; Meinrad Beer; Stephan Eggeling; Wolfgang Gesierich; Jens Gottlieb; Felix Herth; Hans-Stefan Hofmann; Berthold Jany; Michael Kreuter; Julia Ley-Zaporozhan; Robert Scheubel; Thorsten Walles; Sebastian Wiesemann; Heinrich Worth; Erich Stoelben

doi:10.1055/a-0588-4444

Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie, Inhaltsverzeichnis

Zentralbl Chir 2018; 143(S 01): S12-S43
DOI: 10.1055/a-0588-4444

Guideline/Leitlinie

Georg Thieme Verlag KG Stuttgart · New York

Management of Spontaneous Pneumothorax and Postinterventional Pneumothorax: German S3-Guideline^[*]

Artikel in mehreren Sprachen: English | deutsch

Autor*innen

Jost Schnell

¹Lungenklinik Köln-Merheim, Lehrstuhl Thoraxchirurgie der Universität Witten-Herdecke
Meinrad Beer

²Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm
Stephan Eggeling

³Klinik für Thoraxchirurgie, Vivantes Klinikum Neukölln, Berlin
Wolfgang Gesierich

⁴Klinik für Pneumologie, Asklepios-Fachkliniken München Gauting
Jens Gottlieb

⁵Klinik für Pneumologie, Medizinische Hochschule Hannover
Felix Herth

⁶Abteilung für Pneumologie und Beatmungsmedizin, Thoraxklinik Universitätsklinikum Heidelberg
Hans-Stefan Hofmann

⁷Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg
Berthold Jany

⁸Medizinische Klinik - Schwerpunkt Pneumologie und Beatmungsmedizin, KWM Missioklinik Würzburg
Michael Kreuter

⁶Abteilung für Pneumologie und Beatmungsmedizin, Thoraxklinik Universitätsklinikum Heidelberg
Julia Ley-Zaporozhan

⁹Klinik und Poliklinik für Radiologie, Klinikum der Ludwig-Maximilans-Universität München
Robert Scheubel

¹⁰Klinik für Thoraxchirurgie, Fachkliniken Wangen
Thorsten Walles

¹¹Abteilung Thoraxchirurgie, Universitätsklinik für Herz- und Thoraxchirurgie Magdeburg
Sebastian Wiesemann

¹²Klinik für Thoraxchirurgie, Universitätsklinikum Freiburg
Heinrich Worth

¹³Klinik für Herz- und Lungenerkrankungen, Klinikum Fürth
Erich Stoelben

¹Lungenklinik Köln-Merheim, Lehrstuhl Thoraxchirurgie der Universität Witten-Herdecke

Abstract

In Germany, 10,000 cases of spontaneous pneumothorax are treated inpatient every year. The German Society for Thoracic Surgery (DGT), in co-operation with the German Society for Pulmonology (DGP), the German Radiological Society (DRG) and the German Society of Internal Medicine (DGIM) has developed an S3 guideline on spontaneous pneumothorax and postinterventional pneumothorax moderated by the German Association of Scientific Medical Societies (AWMF).

Method Based on the source guideline of the British Thoracic Society (BTS2010) 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 three 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 (VATS). 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 postinterventional 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.

Key words

spontaneous pneumothorax - pneumothorax - primary spontaneous pneumothorax - secondary spontaneous pneumothorax - postinterventional pneumothorax - chest tube - VATS

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Referenzen

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Management of Spontaneous Pneumothorax and Postinterventional Pneumothorax: German S3-Guideline[*]

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Management of Spontaneous Pneumothorax and Postinterventional Pneumothorax: German S3-Guideline^[*]