[Management of primary spontaneous pneumothorax in France: An overview of practices in 2024]

French guidelines on the management of primary spontaneous pneumothorax (PSP) were first communicated in 2022 and subsequently published in 2023. They emphatically promoted outpatient management. We aimed to assess current therapeutic management of PSP following the release of these guidelines.

A nationwide online survey was conducted to evaluate therapeutic management strategies for large PSP without signs of severity. A standardized questionnaire was sent via the French Society of Respiratory Diseases (SPLF) and the French Federation of Pulmonology (FFP). One response per center was requested.

All in all, 98 responses were collected from physicians (91 pulmonologists) representing 81 healthcare facilities, including 33 (40.7 %) general hospitals and 29 university hospitals (35.8 %). The majority of centers managed PSP through hospitalization (71.6 %), primarily via chest tube drainage (64.2 %), most often using small-bore chest tubes (≤14 French, in 76 % of cases). Outpatient management was practiced in 27.2 % of facilities, mainly using chest drainage with a one-way mini-valve (21 %). Analgesic prescriptions and sick leave duration significantly varied.

Following publication of the French guidelines, PSP management has remained predominantly hospital-based, although small-bore chest tubes are commonly used. Outpatient care remains underdeveloped and should be encouraged. Any future update of these guidelines would need to provide more detailed recommendations on analgesia and sick leave.