1. Primary spontaneous pneumothorax in children: A single institutional experience
- Author
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Baruch Klin, Haim Bibi, Ibrahim Abu-Kishk, and Arnon Elizur
- Subjects
Male ,medicine.medical_specialty ,RD1-811 ,medicine.medical_treatment ,Computed tomography ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,medicine ,Humans ,Child ,Retrospective Studies ,medicine.diagnostic_test ,Thoracic Surgery, Video-Assisted ,business.industry ,Medical record ,Pneumothorax ,Primary spontaneous pneumothorax ,Pigtail catheter ,medicine.disease ,eye diseases ,Surgery ,Chest tube ,Treatment Outcome ,Chest Tubes ,030220 oncology & carcinogenesis ,Video-assisted thoracoscopic surgery ,Drainage ,030211 gastroenterology & hepatology ,Bullae ,Presentation (obstetrics) ,business - Abstract
Summary Background The treatment of primary spontaneous pneumothorax (PSP) remains controversial. We aimed to examine the role of chest computed tomography (CT), the advantages of pigtail catheter versus chest tube regarding duration of drainage or hospitalization period, and the impact of small PSP and surgical treatment on recurrence rate. Methods We retrospectively reviewed the medical records of 109 children with PSP (20 years’ period). Patients with recurrent and those with non-recurrent PSP were compared. Results We recorded 183 episodes of PSP (45% recurrences), 89 patients (97%) were male, and the median age at presentation was 16 years. There were no significant differences between recurrence and non-recurrence PSP regarding age, gender, medical background, presentation symptoms, type of chest drain, median hospitalization length and median follow-up period. Recurrences were less frequent among patients who presented with small PSP and were treated conservatively (P = 0.029). PSP was almost always unilateral and the recurrence was observed ipsilateral in almost 80% of the cases. CT was more frequently used and blebs/bullae were more frequently found among patients with recurrent PSP. Pigtail use had no advantage in reducing hospitalization period and surgical procedures prevented recurrences. Conclusion The size of pneumothorax at presentation helps to predict recurrences. There are no differences regarding duration of drainage or hospitalization period in the use of pigtail compared to chest tube. CT helps evaluate findings in the lungs in recurrent cases of PSP and surgery prevents recurrences effectively.
- Published
- 2021