Spontaneous pneumothorax; a multicentre retrospective analysis of emergency treatment, complications and outcomes

Brown, Simon G A; Ball, Emma L; Macdonald, Stephen; Wright, Colleen A.; Taylor, David

doi:10.1111/imj.12398

Cited by 44 publications

(47 citation statements)

References 29 publications

(41 reference statements)

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“…[1][2][3] Several guidelines and consensus statements about the treatment of primary PNTX exist and VATS procedures have become the mainstay of therapy and prevention of recurrences. 5) While long-term results regarding recurrence prevention by VATS for PNTX therapy have been reported extensively in the literature, no data are available concerning recurrence-prone risk behavior of operated patients.…”

Section: Discussionmentioning

confidence: 99%

“…Without specific surgical therapy, recurrence rates of primary PNTX were reported between 4% and 17%, depending on the applied interventional method. [1][2][3] Videothoracoscopic surgery (VATS) including pulmonary wedge resection and parietal pleurectomy has become Ann Thorac Cardiovasc Surg Advance Published Date: December 27, 2017 doi: 10.5761/atcs.oa. the standard of care for PNTX treatment and recurrence prevention.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Recurrence of Spontaneous Pneumothorax Is Not Associated with Allegedly Risk-Prone Lifestyle Conduct

Steger

Sostheim

Leistner

et al. 2018

ATCS

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Purpose: Spontaneous pneumothorax (PNTX) is a common disease frequently operated at specialized thoracic surgery units. Videothoracoscopic surgery (VATS) has become the standard for treatment and recurrence prevention. While there is broad consensus regarding indications and techniques of PNTX surgery, postoperative risks and consecutive patient behavioral advice have not been sufficiently elucidated. Methods: Single-center cohort analysis of 641 patients operated for primary PNTX by VATS over 10 years. Putatively recurrence-prone lifestyle activities (smoking status, flying habits, and scuba diving) and actual occurrence of recurrences were correlated. Results: Follow-up rate was 46% (279/607 patients). Mean time interval between primary operation and follow-up was 61 (range: 5-177) months. In 10 patients (3.6%), a PNTX recurrence was observed. Regarding postoperative risk behavior reported at follow-up, 28% of patients were active smokers (15 ± 7 cigarettes/day), 59% traveled by plane repeatedly, and only two patients did scuba diving (0.7%). Low body-mass-index was associated with an increase in PNTX recurrence, whereas smoking, flying, and scuba diving could not be identified as risk factors. Conclusion: In our study, none of the supposed "classic" lifestyle-associated risk factors for PNTX recurrence after VATS proved to be a significant threat. Postoperative patient behavior might not be constrained by overcautious medical advice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recurrence of Spontaneous Pneumothorax Is Not Associated with Allegedly Risk-Prone Lifestyle Conduct

Steger

Sostheim

Leistner

et al. 2018

ATCS

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“…The other complications are related to iatrogenic complications secondary to injury of the lungs or blood vessels. These include an undrained hemothorax or pneumothorax, empyema, or local infection [2]. Cardiovascular complications, although rare, can occur.…”

Section: Discussionmentioning

confidence: 99%

A Shocking Complication of a Pneumothorax: Chest Tube-Induced Arrhythmias and Review of the Literature

Cardozo

Belgrave

2014

Case Reports in Cardiology

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We describe a patient with a recent chest tube insertion leading to atrial fibrillation with rapid ventricular rate that led to multiple inappropriate internal cardiac defibrillator (ICD) shocks. This is the first reported case of this occurring in a patient with an ICD leading to inappropriate shocks. Our elderly patient with emphysema presented with a spontaneous pneumothorax and developed rapid atrial fibrillation following emergency tube thoracostomy. The patient had a single lead ICD and received multiple inappropriate shocks for the rapid ventricular rate in the therapy zone. Although medical treatment helped stabilize the patient, resolution of the atrial fibrillation occurred only after the chest tube was removed. In a patient with a chest tube or other intrathoracic catheters, maintaining a high index of suspicion that chest tube insertions can cause secondary life threatening cardiovascular complications needs to be considered. In such patients, removal of the device proves to be the most prudent treatment action.

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“…Haemodynamic compromise or significant hypoxia is unusual in primary pneumothorax [39]. In view of the variability of symptoms and signs at presentation, the diagnosis of primary pneumothorax is usually confirmed with radiographic imaging.…”

Section: Clinical Examinationmentioning

confidence: 99%

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

et al. 2015

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Primary spontaneous pneumothorax (PSP) affects young healthy people with a significant recurrence rate. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research.The European Respiratory Society's Scientific Committee established a multidisciplinary team of pulmonologists and surgeons to produce a comprehensive review of available scientific evidence.Smoking remains the main risk factor of PSP. Routine smoking cessation is advised. More prospective data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP, treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is available. Video-assisted thoracic surgery is preferred to thoracotomy as a surgical approach.In first episodes of PSP, aspiration is required only in symptomatic patients. After a persistent or recurrent PSP, definitive treatment including pleurodesis is undertaken. Future randomised controlled trials comparing different strategies are required. @ERSpublications A European Task Force reviews scientific evidence and suggests future research for primary spontaneous pneumothorax

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Spontaneous pneumothorax; a multicentre retrospective analysis of emergency treatment, complications and outcomes

Cited by 44 publications

References 29 publications

Recurrence of Spontaneous Pneumothorax Is Not Associated with Allegedly Risk-Prone Lifestyle Conduct

Recurrence of Spontaneous Pneumothorax Is Not Associated with Allegedly Risk-Prone Lifestyle Conduct

A Shocking Complication of a Pneumothorax: Chest Tube-Induced Arrhythmias and Review of the Literature

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

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