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Disorders of the Pleura |

Management of Spontaneous Pneumothorax

Tarek Djenfi, PhD; Redha Selmani, PhD; Abdelmadjid Djebbar, PhD
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University Hadj Lakhdar Batna, Batna, Algeria


Chest. 2015;148(4_MeetingAbstracts):435A. doi:10.1378/chest.2280584
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Abstract

SESSION TITLE: Disorders of the Pleura Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: The treatment of a primary or secondary spontaneous pneumothorax remains controversial The aim of this study was to compare the efficacy of different therapeutic methods used in the management of pneumothorax.

METHODS: A retrospective study was undertaken at the Pneumology Department of the University Hospital of Batna, Algeria, over a period of three years (January 2011-December 2013), in order to compare observation, simple aspiration and intercostal tube drainage in the management of spontaneous pneumothorax.

RESULTS: 253 cases were collected, including 224 patients Male predominance was noted (218 men / 6 women) Mean age of 35.7 years ranging from 17 to 82 years. 62% were aged less than 35 years. 66.9 % of the patients were smokers with 32.2 % of smoking cessation. Chest x ray showed a total pneumothorax in 204 cases (92.3%) and small pneumothorax in 47 cases (7.7%). Pneumothorax was located to the left in 98 cases (39%), right in 148 (59%) and bilateral in 5 cases (2%). It was inaugural in 73.7 % of cases and recurrent in 26.3 %. Recurrence was ipsilateral in 39 cases and contralateral in 12 cases. The mean recurrence delay was 6.5 months [1 month to 20 years]. Observation was performed as first-line therapy in 172 cases (67.9 %), with 22% of success rate and average hospitalization duration of 5.13 days Simple aspiration was performed as first-line in 46 cases (18.5 %), with a success rate of 43.4 % and as second-line therapy after observation’s failure in 119 cases (45.8 %), with a success rate of 79.9 % and average hospitalization duration of 13 days. Intercostal tube drainage was performed as first in 35 cases and in second-line therapy in 59 cases after failure of simple aspiration or observation with a success rate of 91.4 % and average hospitalization duration of 22 days.

CONCLUSIONS: Through this study, we conclude that the pleural drainage is still more effective than simple aspiration but with a longer hospital stay. Simple aspiration preceded by a rest period remains beneficial than immediately began simple aspiration.

CLINICAL IMPLICATIONS: simple aspiration should be preceded by a rest of 5 days in order to increase the performance of this therapy in the management of spontaneous pneumothorax.

DISCLOSURE: The following authors have nothing to disclose: Tarek Djenfi, Redha Selmani, Abdelmadjid Djebbar

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