Treatment options of spontaneous pneumothorax

Penumothorax is a benign condition with high morbidity and high recurrence rate; and remains a significant clinical problem worldwide. The exact underlying pathogenesis is probably multifocal and is still unclear. The initial approach to the management of spontaneous pneumothorax differs from country to country and it is very difficult to establish an international standard protocol. Needless to say, that the safest and most cost-effective treatment protocol for a particular center should be used. However, first episode of primary spontaneous pneumothorax can be managed conservatively and there is no consensus on optimal treatment of patients presenting with spontaneous pneumothorax specially those with first event. On the contrary, there is some consensus that some treatment is mandatory with second or recurrent spontaneous pneumothorax. Regardless of the chosen therapeutic modality, the treatment goals of spontaneous pneumothorax consist of elimination of the pleural air and also prevention of future recurrence. Therapeutic options include bed rest, oxygen supplementation, manual aspiration, chest tube drainage, thoracoscopic and surgical interventions. Till present, there are no prospective, randomised comparative studies between various treatment strategies but only few between various therapeutic techniques are available.