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DOI: 10.1055/s-0034-1374650
Outcomes of Outpatient Treatment for Primary Spontaneous Pneumothorax Using a Small-Bore Portable Thoracic Drainage Device
Publication History
07 January 2014
27 February 2014
Publication Date:
29 May 2014 (online)
Abstract
Background There is no consensus regarding the initial intervention for primary spontaneous pneumothorax. We report the outcomes of outpatient treatment for primary spontaneous pneumothorax using a portable thoracic drainage device.
Patients and Methods Between April 2007 and December 2011, 99 consecutive patients with a first episode of primary spontaneous pneumothorax were indicated for insertion of a portable thoracic drainage device. All patients were treated with a small-bore portable thoracic drainage device that consists of a flexible 9F silicone catheter with one-way valves and a small plastic chamber. Successful treatment was defined as when the pneumothorax was resolved after the insertion of a portable thoracic drainage device solely on an outpatient basis. Demographic data and treatment outcomes were obtained by a retrospective chart review.
Results Ninety-seven patients (98%) with a first primary spontaneous pneumothorax were discharged from the emergency department after insertion of a portable thoracic drainage device. Ninety-three patients (94%) resolved with outpatient treatment. The median duration of portable thoracic drainage device insertion was 4 days (range, 0–33 days). The recurrence rate after treatment with a portable thoracic drainage device was 34% (32/93). There were two infections (2.0%), two instances of hemothoraces (2.0%), and one severe discomfort at the insertion site (1.0%). There were no cases of tension pneumothorax or reexpansion edema.
Conclusion Outpatient treatment for primary spontaneous pneumothorax using a portable thoracic drainage device had a high success rate with few serious complications and an acceptable recurrence rate.
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References
- 1 Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D. Epidemiology of pneumothorax in England. Thorax 2000; 55 (8) 666-671
- 2 Cran IR, Rumball CA. Survey of spontaneous pneumothoraces in the Royal Air Force. Thorax 1967; 22 (5) 462-465
- 3 Baumann MH, Strange C, Heffner JE , et al; AACP Pneumothorax Consensus Group. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001; 119 (2) 590-602
- 4 MacDuff A, Arnold A, Harvey J ; BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010; 65 (Suppl. 02) ii18-ii31
- 5 De Leyn P, Lismonde M, Ninane V , et al. Guidelines Belgian Society of Pneumology. Guidelines on the management of spontaneous pneumothorax. Acta Chir Belg 2005; 105 (3) 265-267
- 6 Fysh ET, Smith NA, Lee YC. Optimal chest drain size: the rise of the small-bore pleural catheter. Semin Respir Crit Care Med 2010; 31 (6) 760-768
- 7 Ho KK, Ong ME, Koh MS, Wong E, Raghuram J. A randomized controlled trial comparing minichest tube and needle aspiration in outpatient management of primary spontaneous pneumothorax. Am J Emerg Med 2011; 29 (9) 1152-1157
- 8 Lai SM, Tee AK. Outpatient treatment of primary spontaneous pneumothorax using a small-bore chest drain with a Heimlich valve: the experience of a Singapore emergency department. Eur J Emerg Med 2012; 19 (6) 400-404
- 9 Kurihara M, Kataoka H, Ishikawa A, Endo R. Latest treatments for spontaneous pneumothorax. Gen Thorac Cardiovasc Surg 2010; 58 (3) 113-119
- 10 Lee S, Park SY, Bae MK , et al. Efficacy of polyglycolic acid sheet after thoracoscopic bullectomy for spontaneous pneumothorax. Ann Thorac Surg 2013; 95 (6) 1919-1923
- 11 Hassani B, Foote J, Borgundvaag B. Outpatient management of primary spontaneous pneumothorax in the emergency department of a community hospital using a small-bore catheter and a Heimlich valve. Acad Emerg Med 2009; 16 (6) 513-518
- 12 Baumann MH, Strange C. Treatment of spontaneous pneumothorax: a more aggressive approach?. Chest 1997; 112 (3) 789-804
- 13 Sawada S, Watanabe Y, Moriyama S. Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: evaluation of indications and long-term outcome compared with conservative treatment and open thoracotomy. Chest 2005; 127 (6) 2226-2230
- 14 Cardillo G, Facciolo F, Giunti R , et al. Videothoracoscopic treatment of primary spontaneous pneumothorax: a 6-year experience. Ann Thorac Surg 2000; 69 (2) 357-361 , discussion 361–362
- 15 Yabuki H, Tabata T, Sugawara T, Fukaya K, Fujimura S. The influence of difference of surgical procedure for the young spontaneous pneumothorax to the recurrence rate after surgery [in Japanese]. Kyobu Geka 2013; 66 (12) 1033-1040