Small-bore vs. large-bore chest tubes for pneumothorax: a retrospective study

To compare the clinical efficacy and safety of small-bore (≤ 14 Fr) versus large-bore (> 14 Fr) chest tubes in the treatment of pneumothorax.

A retrospective analysis was conducted. Patients were categorized into small-bore and large-bore groups based on the initial drainage tube size. Outcomes, including treatment efficacy, drainage duration, lung re-expansion time, hospital stay, complication rates, and analgesic use, were compared between groups. Subgroup analyses were performed based on pneumothorax type as primary and secondary spontaneous pneumothorax.

In the overall population of 95 patients (55 large-bore, 40 small-bore), no statistically significant differences were found between the two groups regarding treatment efficacy (90.9% vs. 80.0%, P = 0.063), drainage time, lung re-expansion time, or hospital stay. The large-bore group required a significantly higher equivalent dose of analgesics (P = 0.049). Complication rates were similar between groups. In patients with secondary spontaneous pneumothorax (SSP), the small-bore tube group demonstrated significantly shorter drainage duration and lung re-expansion time compared to the large-bore group (both P = 0.007).

In this retrospective analysis, small-bore and large-bore chest tubes demonstrated comparable treatment efficacy for pneumothorax management, with no statistically significant difference observed between groups. The large-bore group required a higher equivalent analgesic dosage, although this finding is exploratory given the borderline statistical significance and absence of validated pain assessment instruments. In the SSP subgroup, small-bore tubes were associated with significantly shorter drainage duration and lung re-expansion time, though these findings warrant further prospective validation.