Current management of spontaneous pneumothorax

https://doi.org/10.4081/monaldi.2005.622

Authors

  • P.E. Van Schil | paul.van.schil@uza.be Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Edegem (Antwerp), Belgium.
  • J.M. Hendriks Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Edegem (Antwerp), Belgium.
  • M.G. De Maeseneer Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Edegem (Antwerp), Belgium.
  • P.R. Lauwers Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Edegem (Antwerp), Belgium.

Abstract

Spontaneous pneumothorax is divided into primary, when there is no underlying lung disease, and secondary, mainly caused by chronic obstructive pulmonary disease. A variety of different non-invasive and invasive treatment options exist. Due to the lack of large randomised controlled trials no level A evidence is present. A first episode of a primary spontaneous pneumothorax is treated by observation if it is 20%, but recurrences are frequent. For recurrent or persisting pneumothorax a more invasive approach is indicated whereby video-assisted thoracic surgery provides a treatment of lung (resection of blebs or bullae) and pleura (pleurectomy or abrasion). In patients with a secondary spontaneous pneumothorax related to chronic obstructive pulmonary disease, there is an associated increased mortality and a more aggressive approach is warranted consisting of initial thoracic drainage followed by recurrence prevention by thoracoscopy or thoracotomy in patients with a low or moderate operative risk. Talc instillation by the thoracic drain is preferred for patients with a high operative risk.

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Published
2005-12-30
Info
Issue
Section
Reviews
Keywords:
Pneumothorax, treatment, COPD, thoracic surgery, talc, thoracic drain
Statistics
  • Abstract views: 371

  • PDF: 260
How to Cite
Van Schil, P.E., J.M. Hendriks, M.G. De Maeseneer, and P.R. Lauwers. 2005. “Current Management of Spontaneous Pneumothorax”. Monaldi Archives for Chest Disease 63 (4). https://doi.org/10.4081/monaldi.2005.622.