Spontaneous pneumothorax management

Abstract

BACKGROUND: The purpose of the present study was to evaluate the current practice habits among clinicians treating primary spontaneous pneumothorax. METHODS: Practice habits were investigated in 55 pulmonologists, 75 general surgeons, 23 thoracic surgeons, all were chiefs of their respective departments, by a postal survey. The mail contained a cover letter requesting the recipients' participation and explaining the purpose of the research and a survey questionnaire. RESULTS: Ninety-seven respondents (63%) included 28 pulmonologists (28/55, 52%), 48 general surgeons (49/75, 64%) and 20 thoracic surgeons (20/23, 87%). Sixty-nine respondents treat first primary spontaneous pneumothorax with chest tube, 25% by simple observation and 6% by aspiration. Seventy four percent of respondents insert chest tube in the second intercostal space midclavicular line and 22% in the fourth intercostal space midaxillary line. Nearly 71% of pulmonologists use <18 F chest tube, 85% of thoracic surgeons insert 20–24 F chest tube. Chest tubes are initially placed to suction by 56% of respondents. Chest tube clamping prior its removal is employed by 74% of clinicians. CONCLUSIONS: Marked practice variation exists in clinicians' approaches to the management of primary spontaneous pneumothorax that is partially explained by differences between pulmonologists and surgeons, and also between thoracic and general surgeons.