Abstract
Background / objectives. The main treatment option for the first episode of primary spontaneous pneumothorax is chest tube drainage, however, whether delayed chest tube removal might influence the recurrence is unclear.Methods. A prospective study, which included 50 patients, with an initial episode of primary spontaneous pneumothorax was performed. Patients were randomized into two groups according to the chest tube removal time: 1-day and 5-days after the air-leak has stopped. All patients were followed-up for at least six months. Both groups were compared according to the recurrence rate and possible complications.Results. There were 39 (78%) men and the median age was 27 (23–35) years. Successful management with a chest tube was achieved in 43 (86%) patients, others were operated on because of the continuous air-leak or relapse of the pneumothorax after the chest tube was removed. Significant difference was not found comparing groups by age, gender, side, tobacco smoking, alpha-1-antitrypsin level, rate of prolonged air-leak, necessity of surgery, and the mean follow-up time. There was a significant difference between groups in hospitalization time: 1-day group – 6 (4–12), 5-days group – 8 (7–10) days, p = 0.017. Five (20%) patients from 1-day group and 3 (12%) from 5-days group had a recurrence, however the difference was not significant (p = 0.702). There were no significant differences comparing groups by the recurrence time or complications.Conclusions. The recurrence rate of primary spontaneous pneumothorax was higher if the chest tube was removed earlier, however not significantly. More data and longer follow-up are necessary to confirm these findings.
Highlights
Pneumothorax is defined as the presence of air in the pleural cavity leading to loss of the negative subatmospheric intrapleural pressure and lung collapse
The aim of this study was to evaluate whether chest tube time influence the recurrence rate of Primary spontaneous pneumothorax (PSP) and whether it is associated with the higher complication rate
Fifty patients with the first episode of PSP were included in the study
Summary
Pneumothorax is defined as the presence of air in the pleural cavity leading to loss of the negative subatmospheric intrapleural pressure and lung collapse. Primary spontaneous pneumothorax (PSP) is a significant health problem and has an age-adjusted incidence of 7.4 to 18 cases per 100 000 population per year in males, and 1.2 to 6 cases per 100 000 population per year in females [3]. It usually occurs in tall, thin males and it is associated with an asthenic or leptosomic physical constitution. It is unclear how to prevent the recurrence of PSP after the first episode managed with a chest tube drainage. The aim of this study was to evaluate whether chest tube time influence the recurrence rate of PSP and whether it is associated with the higher complication rate
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