Objective: To study the outcome of pneumothorax managed
in a university-affiliated metropolitan medical center.
Design: A retrospective review.
Busy metropolitan medical center.
methods: Records of 1,199 patients with pneumothorax were
reviewed and analyzed.
Results: Primary spontaneous
pneumothorax occurred in 218 patients, secondary spontaneous
pneumothorax occurred in 505, traumatic in 403, and iatrogenic in 73.
Ninety-six patients with small pneumothorax (8%) were managed by
observation, and 1,103 patients (92%) were managed by tube
thoracostomy. Drainage of the pleural cavity was continued for 1 to 7
days in 893 patients (81%), 8 to 10 days in 176 patients (16%), and>
10 days in 34 patients (3%). Drainage for > 10 days was
classified as persistent pneumothorax. In these 34 patients and in 132
others with a second ipsilateral recurrence (a total of 166 patients),
direct pleuroscopy was performed. The pleuroscopy findings and further
management are outlined in the algorithm.
Pneumothorax is a common condition affecting all age groups. If the
volume of the pneumothorax is > 20% of the pleural space, pleural
drainage is indicated. For management of persistent or recurrent
pneumothorax, the use of pleuroscopy (direct or video-assisted) is of
great value and should be part of routine