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Clinical Investigations: SURGERY |

Pneumothorax*: Experience With 1,199 Patients

Dov Weissberg, MD, FCCP; Yael Refaely, MD
Author and Funding Information

*From the Department of Thoracic Surgery (Dr. Rafaely), Tel Aviv University Sackler School of Medicine, Tel Aviv; and E. Wolfson Medical Center (Dr. Weissberg), Holon, Israel.

Correspondence to: Dov Weissberg, MD, FCCP, E. Wolfson Medical Center, Holon 58100, Israel.



Chest. 2000;117(5):1279-1285. doi:10.1378/chest.117.5.1279
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Objective: To study the outcome of pneumothorax managed in a university-affiliated metropolitan medical center.

Design: A retrospective review.

Setting: Busy metropolitan medical center.

Patients and 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.

Conclusions: 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 management.

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