Is conventional management of primary spontaneous pneumothorax appropriate?

Tsuboshima, Kenji; Kurihara, Masatoshi; Nonaka, Yuto; Ochi, Takahiro

doi:10.1007/s11748-020-01535-8

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…97 The risk for repeated recurrences (ie, more than 1 recurrence) among patients with PSP treated non-surgically is also believed to be high, ranging from 40% to 83%. 95,[98][99][100][101] However, the referenced literature on the risk of repeated recurrences is based on an adult series that included elderly patients, with smoking rates ranging from 61% to 72%.…”

Section: Recurrencementioning

confidence: 99%

An evidence‐based review of primary spontaneous pneumothorax in the adolescent population

Wilson

Rymeski

et al. 2021

JACEP Open

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Primary spontaneous pneumothorax (PSP) is a relatively common problem in emergency medicine. The incidence of PSP peaks in adolescence and is most common in tall, thin males. Recent advances in the care of patients with PSP have called into question traditional approaches to management. This clinical review highlights the changing management strategies for PSP and concludes with a proposed evidence-based pathway to guide the care of adolescents with PSP.

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Section: Recurrencementioning

confidence: 99%

An evidence‐based review of primary spontaneous pneumothorax in the adolescent population

Wilson

Rymeski

et al. 2021

JACEP Open

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“…Its management involves different physicians, mainly pneumologists and thoracic surgeons; so that, in literature exists many papers on different management strategies that range from the more conservative approaches to the more aggressive ones [ 4 , 13 ]. Much of the debate, however, is focused mainly on the clinical and radiological work-up, and on the best strategy to treat the first PSP episode; while, regarding surgery, only the indication for persistent (>5–7 days) or recurrent pneumothorax could be considered well established [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Cold coagulation in thoracoscopic treatment of primary pneumothorax: a comparison with apicectomy

Aprile

Bacchin

Marrama

et al. 2023

Interdisciplinary CardioVascular and Thoracic Surgery

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Objectives Primary spontaneous pneumothorax is a common disease, whose surgical treatment is still enigmatic in terms of timing and technique. Herein, we reported our experience with the parenchymal sparing technique via cold coagulation, in comparison to stapler apicectomy. Methods We retrospectively collected data of all patients with apical blebs or < 2cm bullae treated with minimally invasive surgery for recurrent or persistent spontaneous pneumothorax, from 2010 to 2020. Two different surgical techniques were used: stapler apicectomy and the parenchymal sparing cold coagulation of the apex. Perioperative and long-term results were analysed and compared. Results Out of 177 patients enrolled, 77 patients (CC-group) underwent cold-coagulation of the apex while 100 patients (SA-group) were treated with stapler apicectomy. Two groups were comparable in terms of age, surgical indication, intraoperative findings and affected side. CC-group had a mean operative time of 43.2 min (SD ± 19.5), shorter than SA-group with 49.3 min (SD ± 20.1, p-value : 0.050). Complications rate was significantly different between two groups, 5 (7%) and 16 (16%), for CC- and SA-group, respectively (p : 0.048), even if not in term of prolonged post-operative air-leak (p : 0.16). During the follow-up, 13 homolateral recurrences were reported: 2 (3%) in group CC and 11 (11%) in group SA; with a significant difference (p : 0.044). All reinterventions (post-operative prolonged air-leak and recurrences) required a stapler apicectomy. Conclusions Parenchymal sparing technique through cold coagulation of apical blebs and bullae is an effective treatment for primary spontaneous pneumothorax and guarantees a good immediate lung sealing, despite stapling still represents the choice treatment in complex cases.

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Current opinion and comparison of surgical procedures for the treatment of primary spontaneous pneumothorax

Tsuboshima

Kurihara

Seyama

2021

Expert Review of Respiratory Medicine

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Is conventional management of primary spontaneous pneumothorax appropriate?

Cited by 4 publications

References 17 publications

An evidence‐based review of primary spontaneous pneumothorax in the adolescent population

An evidence‐based review of primary spontaneous pneumothorax in the adolescent population

Cold coagulation in thoracoscopic treatment of primary pneumothorax: a comparison with apicectomy

Current opinion and comparison of surgical procedures for the treatment of primary spontaneous pneumothorax

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