Spontaneous pneumothorax-When do we need to intervene?
Moshe Ashkenazi1,2, Alon Bak1, Ifat Sarouk1,2
1Pediatric Pulmonology and National CF Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
The Clinical Respiratory Journal
|May 17, 2021
Summary
Surgery significantly reduces spontaneous pneumothorax (SP) recurrence. In young females with SP, investigate underlying lung conditions like asthma. Further research is needed for clear surgical guidelines.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Critical Care Medicine
Background:
- Pneumothorax is categorized as traumatic, iatrogenic, or spontaneous (SP).
- SP includes primary spontaneous pneumothorax (PSP) and secondary spontaneous pneumothorax (SSP) due to underlying lung disease.
- Recurrence rates are 30% for PSP; SSP recurrence is unknown.
Purpose of the Study:
- To investigate the natural history and treatment of SP in patients under 40.
- To analyze recurrence rates and risk factors in a young population.
Main Methods:
- Retrospective case review of hospitalized pneumothorax patients under 40.
- Data collected from Sheba Medical Center's digital archive from January 1995.
Main Results:
- 750 patients (612 males, 138 females) analyzed.
- Nonoperative treatment showed significantly higher SP recurrence risk.
- Women with SP had increased SSP risk (OR 2.78); asthma was the most common cause of SSP in young individuals.
Conclusions:
- Operative procedures offer a protective effect against SP recurrence.
- Surgery should be strongly considered for hospitalized SP patients.
- Investigate primary lung disease in young females with SP; more research is needed for surgical guidelines.
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