Primary spontaneous pneumothorax in children: A single institutional experience
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...
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doaj-fede2bb3a35a4ea48b6fefe07f8fd75c2021-07-09T04:42:10ZengElsevierAsian Journal of Surgery1015-95842021-07-01447969973Primary spontaneous pneumothorax in children: A single institutional experienceBaruch Klin0Arnon Elizur1Haim Bibi2Ibrahim Abu-Kishk3Pediatric Division, Shamir Medical Center (Assaf Harofeh), Zerifin, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Division, Shamir Medical Center (Assaf Harofeh), Zerifin, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Division, Shamir Medical Center (Assaf Harofeh), Zerifin, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, IsraelCorresponding author. Pediatric Intensive Care Unit, Shamir Medical Center (Assaf Harofeh), Zerifin, 7033001, Israel.; Pediatric Division, Shamir Medical Center (Assaf Harofeh), Zerifin, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, IsraelSummary: 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.http://www.sciencedirect.com/science/article/pii/S1015958421000695PneumothoraxComputed tomographyVideo-assisted thoracoscopic surgeryBullaeRecurrence |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Baruch Klin Arnon Elizur Haim Bibi Ibrahim Abu-Kishk |
spellingShingle |
Baruch Klin Arnon Elizur Haim Bibi Ibrahim Abu-Kishk Primary spontaneous pneumothorax in children: A single institutional experience Asian Journal of Surgery Pneumothorax Computed tomography Video-assisted thoracoscopic surgery Bullae Recurrence |
author_facet |
Baruch Klin Arnon Elizur Haim Bibi Ibrahim Abu-Kishk |
author_sort |
Baruch Klin |
title |
Primary spontaneous pneumothorax in children: A single institutional experience |
title_short |
Primary spontaneous pneumothorax in children: A single institutional experience |
title_full |
Primary spontaneous pneumothorax in children: A single institutional experience |
title_fullStr |
Primary spontaneous pneumothorax in children: A single institutional experience |
title_full_unstemmed |
Primary spontaneous pneumothorax in children: A single institutional experience |
title_sort |
primary spontaneous pneumothorax in children: a single institutional experience |
publisher |
Elsevier |
series |
Asian Journal of Surgery |
issn |
1015-9584 |
publishDate |
2021-07-01 |
description |
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. |
topic |
Pneumothorax Computed tomography Video-assisted thoracoscopic surgery Bullae Recurrence |
url |
http://www.sciencedirect.com/science/article/pii/S1015958421000695 |
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