SPLF/SMFU/SRLF/SFAR/SFCTCV Guidelines for the management of patients with primary spontaneous pneumothorax

Abstract

Introduction Primary spontaneous pneumothorax (PSP) is the presence of air in the pleural space, occurring in the absence of trauma and known lung disease. Standardized expert guidelines on PSP are needed due to the variety of diagnostic methods, therapeutic strategies and medical and surgical disciplines involved in its management. Methods Literature review, analysis of the literature according to the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) methodology; proposals for guidelines rated by experts, patients and organizers to reach a consensus. Only expert opinions with strong agreement were selected. Results A large PSP is defined as presence of a visible rim along the entire axillary line between the lung margin and the chest wall and ≥ 2 cm at the hilum level on frontal chest X-ray. The therapeutic strategy depends on the clinical presentation: emergency needle aspiration for tension PSP; in the absence of signs of severity: conservative management (small PSP), needle aspiration or chest tube drainage (large PSP). Outpatient treatment is possible if a dedicated outpatient care system is previously organized. Indications, surgical procedures and perioperative analgesia are detailed. Associated measures, including smoking cessation, are described. Conclusion These guidelines are a step towards PSP treatment and follow-up strategy optimization in France.

Implementation of Individualized Low-Dose Computed Tomography-Guided Hook Wire Localization of Pulmonary Nodules: Feasibility and Safety in the Clinical Setting

“…The overall frequency of intrapulmonary hemorrhage and pneumothorax did not differ significantly across all groups. All pneumothoraces observed in our study were classified as asymptomatic small pneumothorax [30,31], and none of them required further intervention before surgery. No serious complications such as hemoptysis, massive hemothorax or air embolisms were identified in either group.…”

Traumatic Open Pneumothorax in one of Bogor Rural Hospital Area : A Case Report

“…In this case, the chest CT-scan outperforms the CXR in evaluating pneumothorax size and identifying the causes of secondary pneumothorax. Nevertheless, due to factors such as cost, time constraints, and radiation exposure, it is not recommended as the initial diagnostic examination (Jouneau et al, 2023).…”

Incidence and risk factors for recurrent primary spontaneous pneumothorax after video-assisted thoracoscopic surgery: a systematic review and meta-analysis

“…Primary spontaneous pneumothorax (PSP) is a type of spontaneous pneumothorax which occurs in the absence of any trauma or underlying lung disease ( 1 , 2 ). Previous study reported an annual incidence of PSP of 7.4 and 1.2 cases per 100,000 men and women, respectively ( 3 ).…”