Management of primary and secondary pneumothorax using a small-bore thoracic catheter

This study aimed to investigate the efficacies and complications associated with the 7F catheter inserted in patients with pneumothorax in the emergency room and to compare the results for primary and secondary pneumothorax. From June 2006 to May 2008, 200 patients with primary or secondary pneumothorax treated with a 7F catheter were enrolled. The primary endpoint was the immediate success rate. Success with the 7F catheter was defined as complete or nearly complete lung expansion following insertion without the need for a conventional chest tube or surgical treatment. One hundred fifty-four patients were diagnosed with primary pneumothorax, 38 patients with secondary pneumothorax, and eight patients with iatrogenic pneumothorax. Treatment for 48 of the 200 patients (24.0%) failed; 30 patients were given a conventional chest tube and 18 patients had surgical resections without a conventional chest tube. The failure group included 26 patients (16.9%) with primary, 20 patients (52.6%) with secondary, and two patients (25%) with iatrogenic pneumothorax. The failure rate of patients with secondary pneumothorax was significantly higher than that of patients with primary pneumothorax (P<0.05). We can confirm that the 7F catheter is an effective approach to the treatment of primary pneumothorax, including first, recurrent, and postoperative pneumothorax.