Management of Primary Spontaneous Pneumothorax in Children

Seguier‐Lipszyc, Emmanuelle; Elizur, Arnon; Klin, Baruch; Vaiman, Michael; Lotan, Gad

doi:10.1177/0009922811404699

Cited by 58 publications

(65 citation statements)

References 31 publications

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“…The role of blebs/bullae as a preexistent lesion for development of PSP has been questioned; in fact, some studies observed no correlation between its presence and the risk for PSP recurrence (6,8,9,11,12,(14)(15)(16)(17). However, there is some evidence on the lack of association between blebs and different recurrent patterns of PSP (ipsilateral or contralateral).…”

Section: Discussionmentioning

confidence: 99%

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

Chen¹,

Huang²,

Chang³

et al. 2016

J. Thorac. Dis.

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IntroductionPrimary spontaneous pneumothorax (PSP) usually occurs in young, tall, and lean men, especially smokers with no obvious underlying lung disease. It arguably results from rupture of subpleural blebs or bullae. The most frequent complication of PSP is recurrence, which is estimated to occur in 20% to 60% after conservative treatment (1,2). More than 50% of patients with PSP have contralateral blebs/bullae and about a quarter will develop contralateral pneumothorax (3). The British Thoracic Society (BTS) guidelines include first recurrence of contralateral pneumothorax and synchronous bilateral PSP as the only indications for surgery of the contralateral lung (4). However, surgery of the contralateral lung to prevent possible complications remains controversial (5-7). To date, only few studies on small populations have discussed both ipsilateral and contralateral recurrences of PSP. The purpose of our study was to identify the predictors of ipsilateral and contralateral recurrences of PSP and to review literatures on the association of blebs/bullae on high resolution computed tomography (HRCT) of the chest with PSP recurrence. Knowing the risk factors for PSP recurrence may enable us to optimize patient selection to avoid further recurrence and complications.

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Section: Discussionmentioning

confidence: 99%

Postoperative predictors of ipsilateral and contralateral recurrence in patients with primary spontaneous pneumothorax

Chen¹,

Huang²,

Chang³

et al. 2016

J. Thorac. Dis.

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show abstract

“…5,10,20,21) The incidence of blebs/bullae on HRCT scans in paediatric population studies was reported to range from 30.8% to 100%, 6,14,17,19,20,22) and the recurrence rate after conservative treatment in patients with air-containing lesions was reported to range from 50% to 100% (Table 4). 6,17,19) These results are consistent with the results of our study of an incidence of blebs/bullae on HRCT scans of 55.3% (63/114) and the 60.3% recurrence rate associated with blebs/bullae on HRCT scans. However, prior studies in the paediatric population were limited by the small number of enrolled patients, which mitigates the significance of the association between air-containing lesions on CT scans and the recurrence of paediatric PSP.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6] Surgery represents the most effective method for preventing recurrence. However, prevention of recurrence after an initial episode of PSP in children remains controversial.…”

mentioning

confidence: 99%

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What Factors Predict Recurrence after an Initial Episode of Primary Spontaneous Pneumothorax in Children?

Choi

Park

Song

et al. 2014

ATCS

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“…Some studies have shown that CT itself is poor for bleb identification, and that recurrence rates are similar between those with and without blebs. 11,12 In addition, an evidence-based management article from 2009 stated that there is no indication for the use of CT for bleb or bullae assessment after the initial occurrence of SP, 13 and this is in concordance with a 2001 consensus statement from the American College of Chest Physicians (ACCP). 14 However, a retrospective review from 2013 of 114 children undergoing conservative management after primary PSP found that the presence of blebs or bullae on high-resolution CT was a significant risk factor for ipsilateral recurrence.…”

Section: Management Of Spontaneous Pneumothoraxmentioning

confidence: 64%