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Primary spontaneous pneumothorax

Winnie Hedevang Olesen, Niels Katballe, Jesper Eske Sindby, Ingrid Louise Titlestad, Poul Erik Andersen, Rune Lindahl-Jacobsen, Peter Bjørn Licht
OBJECTIVES: Primary spontaneous pneumothorax frequently recurs after chest tube management. Evidence is lacking whether patients may benefit from surgery following their first episode. METHODS: We performed a multicentre, randomized trial and enrolled young, otherwise healthy patients admitted with their first episode of primary spontaneous pneumothorax and treated using conventional chest tube drainage. Patients underwent high-resolution computed tomography on fully expanded lungs, and using web-based randomization, we assigned patients to continued conservative chest tube treatment or chest tube treatment followed by video-assisted thoracoscopic surgery (VATS) with the resection of bullae/blebs and mechanical pleurodesis...
March 2, 2018: European Journal of Cardio-thoracic Surgery
Yannan J Wang, Elsio Negron-Rubio, Jayanth H Keshavamurthy, William B Bates
A 25-year-old man with a history of Marfan syndrome, asthma and smoking presented with worsening dyspnoea and right-sided chest pain worsened with deep breathing after a fall 2 days prior. Diagnostic imaging revealed a spontaneous right-sided pneumothorax due to ruptured subpleural bullae in the apex of the right lung. Smaller subpleural bullae were also noted in the apex of the left lung. A chest tube was placed to reduce the right pneumothorax successfully.
February 27, 2018: BMJ Case Reports
Ali Cevat Kutluk, Celalettin Ibrahim Kocaturk, Hasan Akin, Sertan Erdogan, Salih Bilen, Kemal Karapinar, Celal Bugra Sezen, Ozkan Saydam
OBJECTIVE:  Video-assisted thoracoscopic surgery (VATS) has become the standard treatment method for primary spontaneous pneumothorax. Concerns about lesser pain and better cosmesis led to the evolution of uniportal access. This study prospectively compared the results of the uniportal, two-port, and three-port thoracoscopic surgery. MATERIAL AND METHODS:  One hundred and thirty-five patients were randomized into three groups according to the port numbers. The groups were compared regarding the operation time, hospital stay, amount of drainage, area of pleurectomy, complications, recurrences, and pain scores...
February 20, 2018: Thoracic and Cardiovascular Surgeon
Su-Huan Chang, Yi-No Kang, Hsin-Yi Chiu, Yu-Han Chiu
BACKGROUND: The optimal initial treatment approach for pneumothorax remains controversial. This systemic review and meta-analysis investigated the effectiveness of small-bore pigtail catheter (PC) drainage in comparison with that of large-bore chest tube (LBCT) drainage as the initial treatment approach for all subtypes of pneumothorax. METHODS: We systematically searched PubMed and Embase for observational studies and randomized controlled trials published up to October 9, 2017, that compared PC and LBCT as the initial treatment for pneumothorax...
February 13, 2018: Chest
Shilpa Sharma
No abstract text is available yet for this article.
February 15, 2018: Indian Journal of Pediatrics
Yasser Aljehani, Feras Almajid, Hind Alsaif
INTRODUCTION: Patients with primary spontaneous pneumothorax (PSP) rarely presented with radiological signs of tension pneumothorax on their presenting chest X-ray. Even though, those patients may not develop the hemodynamic instability that is seen in tension pneumothorax. The aim of this study is to elaborate whether the presence of radiological signs of tension pneumothorax in patients with PSP will affect their clinical presentation. METHODS: Retrospective study of all cases of PSP over a period from January 2007 to December 2014...
February 6, 2018: Emergency Radiology
Laurits Frøssing, Lars Pedersen, Saher Shaker
Birt-Hogg-Dubé syndrome (BHD) is an autosomal-dominant genodermatosis manifesting as a multisystemic disorder. The most common presentation of pulmonary involvement is spontaneous pneumothorax, and it has recently been estimated, that up to 5-10% of patients with primary spontaneous pneumothorax have underlying BHD. The purpose of this case report is to stress the paramount importance of a thorough family history in patients with spontaneous pneumothorax and to recommend, that patients with a spontaneous pneumothorax and a personal or family history of pneumothorax should be screened for BHD...
January 29, 2018: Ugeskrift for Laeger
Peter Rodgers-Fischi, Krishna Subhash Vyas, Daniel Davenport, Sibu Pada Saha
Objectives: Management of patients with primary spontaneous pneumothorax is controversial. We sought to review our experience in the treatment of primary spontaneous pneumothorax (PSP) by comparing outcomes from video-assisted thoracoscopic surgery (VATS) with thoracotomy. A retrospective review of electronic and paper medical charts identified 104 consecutive operations performed at University of Kentucky Chandler Medical Center for spontaneous pneumothorax management between the dates of January 2000 and January 2013...
March 2017: West Virginia Medical Journal
Lisa M Soler, Steven L Raymond, Shawn D Larson, Janice A Taylor, Saleem Islam
PURPOSE: The management of primary spontaneous pneumothorax (PSP) in the pediatric population is not standardized. The purpose of this study was to understand the management options for a first episode of PSP in children and adolescents, and their associated outcomes. METHODS: A retrospective study was conducted for patients 5-20 years old with a diagnosis of PSP at a large academic children's hospital between 2002 and 2014. Patient data were reviewed for each case...
December 27, 2017: Journal of Pediatric Surgery
Chul Hwan Park, MinDong Sung, Geun Dong Lee, Young Woo Do, Hee Min Park, Junu Kim, Jin Hur, Kyunghwa Han, Tae Hoon Kim, Jason Jungsik Song, Sungsoo Lee
BACKGROUND: We compared the chest configurations of patients with primary spontaneous pneumothorax (PSP) and age-sex-matched controls to determine the presence of chest wall deformities in patients with PSP. METHODS: We retrospectively enrolled 166 male patients with PSP (age, 18-19 years) and 85 age-sex-matched controls without PSP, who simultaneously underwent chest computed tomography (CT) and radiography at one of two institutes. After correcting for height, the following thoracic parameters were comparatively evaluated between the two groups: maximal internal transverse ( T ) and anteroposterior ( W ) diameters of the chest, maximal internal lung height ( H ), Haller index ( T / W ), and T /Height, T / H , W /Height, W / H , and H /Height ratios...
January 19, 2018: Thoracic and Cardiovascular Surgeon
Chan Beom Park, Mi Hyoung Moon, Hyun Woo Jeon, Deog Gon Cho, Sun Wha Song, Yoo Dong Won, Yong Hwan Kim, Young-Du Kim, Seong Cheol Jeong, Kyung Soo Kim, Si Young Choi
Background: Patients with small pneumothoraces are usually treated with oxygen therapy. However, evidence that oxygen therapy increases resolution rate is based on small populations with secondary spontaneous pneumothorax. Therefore, this study aimed to confirm whether oxygen therapy increases the resolution rate of primary spontaneous pneumothorax (PSP). Methods: We retrospectively reviewed records of patients with PSP who had undergone outpatient observation (room air group) and those who were admitted for oxygen therapy (O2 group) between March 2005 and February 2016...
December 2017: Journal of Thoracic Disease
Hans-Stefan Hofmann, Tobias Suttner, Reiner Neu, Tobias Potzger, Tamas Szöke, Christian Grosser, Michael Ried
BACKGROUND:  The optimal treatment of primary spontaneous pneumothorax (PSP) is still controversial. The purpose of this study was to analyze the incidence of recurrence, the recurrence-free time, and to identify risk factors for recurrence after PSP. METHODS:  We performed a retrospective analysis of 135 patients with PSP who were treated either conservatively with a chest tube (n = 87) or surgically with video-assisted thoracoscopic surgery (VATS; n = 48) from January 2008 through December 2012...
December 31, 2017: Thoracic and Cardiovascular Surgeon
Rachel M Scott, Elizabeth P Henske, Benjamin Raby, Philip M Boone, Rosemary A Rusk, Stefan J Marciniak
One in 10 patients suffering from primary spontaneous pneumothoraces has a family history of the disorder. Such familial pneumothoraces can occur in isolation, but can also be the presentation of serious genetic disorders with life-threatening vascular or cancerous complications. As the pneumothorax frequently precedes the more dangerous complications by many years, it provides an opportunity to intervene in a focused manner, permitting the practice of precision medicine. In this review, we will discuss the clinical manifestations and underlying biology of the genetic causes of familial pneumothorax...
March 2018: Thorax
W Muhsen, R Roy
INTRODUCTION: Despite recent advances in respiratory support, the wide use of antenatal steroids and surfactant replacement therapy, respiratory problems continue to represent the leading cause of mortality in premature infants during the neonatal period. In the last few years, HHHFNC has been widely adopted as a mode of noninvasive respiratory support for infants with respiratory difficulties. However, data of the safety and efficacy of HHHFNC use in extremely premature infants are scarce...
December 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
Volker Steger, Ulrike Sostheim, Marcus Leistner, Thorsten Walles
PURPOSE: Spontaneous pneumothorax (PNTX) is a common disease frequently operated at specialized thoracic surgery units. Videothoracoscopic surgery (VATS) has become the standard for treatment and recurrence prevention. While there is broad consensus regarding indications and techniques of PNTX surgery, postoperative risks and consecutive patient behavioral advice have not been sufficiently elucidated. METHODS: Single-center cohort analysis of 641 patients operated for primary PNTX by VATS over 10 years...
December 27, 2017: Annals of Thoracic and Cardiovascular Surgery
Kibileri Williams, Timothy B Lautz, Astrid H Leon, Tolulope A Oyetunji
PURPOSE: There is no consensus in the pediatric surgical community about when to recommend video-assisted thoracoscopic surgery (VATS) for patients with primary spontaneous pneumothorax (PSP). We aimed to identify factors that predict the likelihood of requiring VATS, and to compare recurrence rates and healthcare utilization among different management approaches to PSP. METHODS: A retrospective chart review and a telephone survey were conducted on all patients 12-21years who were diagnosed with PSP from 2007 to 2015...
November 23, 2017: Journal of Pediatric Surgery
Akihisa Mitani, Yukichika Hakamata, Megumi Hosoi, Masafumi Horie, Yoko Murano, Akira Saito, Shintaro Yanagimoto, Shoji Tsuji, Kazuhiko Yamamoto, Takahide Nagase
BACKGROUND: Patients with primary spontaneous pneumothorax (PSP) usually complain of sudden-onset dyspnea and pleuritic chest pain. However, asymptomatic PSP has been incidentally detected on chest X-rays. In this study, we analyzed the incidence, characteristics, risk factors, and prognosis of asymptomatic PSP detected during regular medical check-ups in university students. METHODS: In this study, 101,709 chest X-rays were performed during medical check-ups for students at the University of Tokyo between April 2011 and March 2016...
December 7, 2017: BMC Pulmonary Medicine
Pang-Yen Liu, Yen-Po Lin, Yi-Hwei Li, Zhi-Wei Su, Chih-Lu Han, Shih-Chung Huang, Chin-Sheng Lin, Fan-Chun Meng, Hsien-Tsai Wu, Gen-Min Lin
OBJECTIVE: To investigate the 12-lead surface electrocardiographic (ECG) findings in young male patients with left primary spontaneous pneumothorax (PSP) estimated by the Collins equation. METHODS: From 2003 through 2008, 60 young male patients who had left PSP and 61 age-matched unaffected males were included for 12-lead ECG analyses. The PSP size was estimated by the Collins equation. Those with left PSP were divided into two groups: 1) large PSP ≥30% (n=37), and 2) small PSP <30% (n=23)...
November 2017: Indian Heart Journal
Sukki Cho, Sanghoon Jheon, Dong Kwan Kim, Hyeong Ryul Kim, Dong Myung Huh, Sungsoo Lee, Kyoung Min Ryu, Deog Gon Cho
OBJECTIVES: This study aimed to identify the causes of recurrent pneumothorax and to evaluate the results of repeated video-assisted thoracic surgery (VATS) for recurrent pneumothorax after VATS wedge resection for primary spontaneous pneumothorax (PSP). METHODS: A retrospective review was conducted on 188 patients with recurrent PSP, of a population of 1414 patients who underwent VATS wedge resection for PSP. Reoperations were performed when an air leak persisted longer than 3 days after closed thoracostomy, when a visible bulla of greater than 1 cm on high-resolution computed tomography (HRCT) was observed and when rerecurrence took place after other treatments...
April 1, 2018: European Journal of Cardio-thoracic Surgery
Imad-Ud-Din Saqib, Mobeen Iqbal, Atif Rana, Saira Hassan
Introduction Pleural effusion is the excess fluid that accumulates in the pleural space. Pneumothorax is the collection of free air in the pleural cavity, while empyema is the collection of pus in the pleural cavity. Such pleural pathologies pose a great challenge to patients and health care professionals alike. While multiple management options exist, the major portion of it is carried out in the inpatient setting. We sought to evaluate the ambulatory use of indwelling pleural catheters for pleural pathologies, including malignant pleural effusion, empyema, and primary spontaneous pneumothorax...
September 1, 2017: Curēus
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