0
Disorders of the Pleura |

Are Large Primary Spontaneous Pneumothoraces Always a Surgical Alternative?

Evaldo Marchi*, MD; Tiago Ventureli, MD; Tiago Santos, MD; Marcus Carvalho, MD; Andre Fruchi, PT; Richard Light, MD
Author and Funding Information

Jundiai Medical College, Jundiai, Brazil


Chest. 2012;142(4_MeetingAbstracts):490A. doi:10.1378/chest.1389006
Text Size: A A A
Published online

Abstract

SESSION TYPE: Pleural Disease

PRESENTED ON: Sunday, October 21, 2012 at 01:15 PM - 02:45 PM

PURPOSE: To describe the outcome of a series of patients with primary spontaneous pneumothorax (PSP) of large volume treated with clinical observation.

METHODS: Patients with PSP (n= 101) were treated either by clinical observation, chest drainage or surgery (thoracoscopy or open thoracotomy). Small size PSP were preferably treated by clinical observation and large size PSP with pleural drainage. However, a subgroup of patients with large PSP, non-smokers, with good clinical status and no previous episodes of pneumothorax were referred to non surgical treatment. Results of this subgroup were compared with patients with small size PSP treated clinically and with patients with large size PSP submitted to pleural drainage. Statistics: Anova (p< 0.05).

RESULTS: Clinical observation was the treatment of choice in 32 and pleural drainage in 35 patients. Twenty-one patients with clinical observation (66%) had small and 11 (34%) large size PSP. Age, degree of dyspnea and the side of PSP did not differ among groups. Non-smoker women with no previous episodes of PSP and large size PSP were more frequent referred for clinical treatment. In this particular subgroup of patients, complete remission time did not differ for small or larger size PSP. Sex (masc): Clin Small (81%), Clin Large (45%*) and Drainage (63%) (p< 0.05); Smoke hab (yes): Clin Small (19%), Clin Large (0%*) and Drainage (34%) (p< 0.05); PSP Prev. Epis. (yes): Clin Small (14%), Clin Large (0%*) and Drainage (11%) (p< 0.05); Remission time (days): Clin Small (11 ± 2.5), Clin Large (17 ± 4.0) and Drainage (3.2 ± 2.2*); (p< 0.05).

CONCLUSIONS: Remission time after treatment was shorter in patients with large PSP submitted to pleural drainage in comparison to clinically treated patients, as expected. However, no difference was found in remission time in clinical treated patients with small or large PSP.

CLINICAL IMPLICATIONS: Although large size PSP are preferably treated with thoracentesis or pleural drainage, a select group of clinically stable patients with large size PSP, non smoking habits and no previous episodes of PSP may benefit from clinical observation alone.

DISCLOSURE: The following authors have nothing to disclose: Evaldo Marchi, Tiago Ventureli, Tiago Santos, Marcus Carvalho, Andre Fruchi, Richard Light

No Product/Research Disclosure Information

Jundiai Medical College, Jundiai, Brazil

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543