Spontaneous pneumothorax: determinants of surgical intervention
To assess the long term efficacy of intercostal tube drainage for spontaneous pneumothorax and determine the clinical parameters associated with surgery. Retrospective analysis with a mean follow-up of 62.3+/-19.3 months (range 23 to 94 months). Riyadh Medical Complex, Riyadh (Saudi Arabia), the big...
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Published in | Journal of cardiovascular surgery Vol. 39; no. 1; pp. 107 - 111 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Italy
Edizioni Minerva Medica
01.02.1998
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Subjects | |
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Abstract | To assess the long term efficacy of intercostal tube drainage for spontaneous pneumothorax and determine the clinical parameters associated with surgery.
Retrospective analysis with a mean follow-up of 62.3+/-19.3 months (range 23 to 94 months).
Riyadh Medical Complex, Riyadh (Saudi Arabia), the biggest referral centres for Ministry of Health providing specialized hospital care.
Over a period of six year, 123 patients had 182 episodes of spontaneous pneumothorax. Male to female ratio was 29.75:1 (p=0.00001). Average age was 26.35+/-8.33 years for men and 37.25+/-14.6 years for women (p=0.01). Seventy eight per cent of patients were aged 11 to 30 years (p=0.00001). Majority were nonsmokers (100/123, p=0.00001). It was first episode of spontaneous pneumothorax for 86 patients. Other 37 patients had 57 episodes previously (mean 1.54+/-0.73; range 1 to 4).
Intercostal tube drainage for all patient with spontaneous pneumothorax. Limited axillary thoracotomy with bullectomy and pleuroabrasion for 32 patients not responding to intercostal tube drainage.
Intercostal tube drainage alone had success rate of 90.7% in first, 52.4% in second, 15.4% in third and 0% for more than 3 episodes of spontaneous pneumothorax. Among the 32 patients who underwent surgery, only one had early recurrence that did not require drainage. We found that patients with history of recurrence, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung were more liable to undergo surgical intervention (p=0.00001 for all variables).
We recommend early surgery to hasten recovery and shorten the hospital stay in patients with history of recurrent spontaneous pneumothorax, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung. |
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AbstractList | OBJECTIVETo assess the long term efficacy of intercostal tube drainage for spontaneous pneumothorax and determine the clinical parameters associated with surgery.EXPERIMENTAL DESIGNRetrospective analysis with a mean follow-up of 62.3+/-19.3 months (range 23 to 94 months).SETTINGRiyadh Medical Complex, Riyadh (Saudi Arabia), the biggest referral centres for Ministry of Health providing specialized hospital care.PATIENTSOver a period of six year, 123 patients had 182 episodes of spontaneous pneumothorax. Male to female ratio was 29.75:1 (p=0.00001). Average age was 26.35+/-8.33 years for men and 37.25+/-14.6 years for women (p=0.01). Seventy eight per cent of patients were aged 11 to 30 years (p=0.00001). Majority were nonsmokers (100/123, p=0.00001). It was first episode of spontaneous pneumothorax for 86 patients. Other 37 patients had 57 episodes previously (mean 1.54+/-0.73; range 1 to 4).INTERVENTIONSIntercostal tube drainage for all patient with spontaneous pneumothorax. Limited axillary thoracotomy with bullectomy and pleuroabrasion for 32 patients not responding to intercostal tube drainage.RESULTSIntercostal tube drainage alone had success rate of 90.7% in first, 52.4% in second, 15.4% in third and 0% for more than 3 episodes of spontaneous pneumothorax. Among the 32 patients who underwent surgery, only one had early recurrence that did not require drainage. We found that patients with history of recurrence, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung were more liable to undergo surgical intervention (p=0.00001 for all variables).CONCLUSIONSWe recommend early surgery to hasten recovery and shorten the hospital stay in patients with history of recurrent spontaneous pneumothorax, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung. To assess the long term efficacy of intercostal tube drainage for spontaneous pneumothorax and determine the clinical parameters associated with surgery. Retrospective analysis with a mean follow-up of 62.3+/-19.3 months (range 23 to 94 months). Riyadh Medical Complex, Riyadh (Saudi Arabia), the biggest referral centres for Ministry of Health providing specialized hospital care. Over a period of six year, 123 patients had 182 episodes of spontaneous pneumothorax. Male to female ratio was 29.75:1 (p=0.00001). Average age was 26.35+/-8.33 years for men and 37.25+/-14.6 years for women (p=0.01). Seventy eight per cent of patients were aged 11 to 30 years (p=0.00001). Majority were nonsmokers (100/123, p=0.00001). It was first episode of spontaneous pneumothorax for 86 patients. Other 37 patients had 57 episodes previously (mean 1.54+/-0.73; range 1 to 4). Intercostal tube drainage for all patient with spontaneous pneumothorax. Limited axillary thoracotomy with bullectomy and pleuroabrasion for 32 patients not responding to intercostal tube drainage. Intercostal tube drainage alone had success rate of 90.7% in first, 52.4% in second, 15.4% in third and 0% for more than 3 episodes of spontaneous pneumothorax. Among the 32 patients who underwent surgery, only one had early recurrence that did not require drainage. We found that patients with history of recurrence, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung were more liable to undergo surgical intervention (p=0.00001 for all variables). We recommend early surgery to hasten recovery and shorten the hospital stay in patients with history of recurrent spontaneous pneumothorax, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung. OBJECTIVE: To assess the long term efficacy of intercostal tube drainage for spontaneous pneumothorax and determine the clinical parameters associated with surgery. EXPERIMENTAL DESIGN: Retrospective analysis with a mean follow-up of 62.3+/-19.3 months (range 23 to 94 months). SETTING: Riyadh Medical Complex, Riyadh (Saudi Arabia), the biggest referral centres for Ministry of Health providing specialized hospital care. PATIENTS: Over a period of six year, 123 patients had 182 episodes of spontaneous pneumothorax. Male to female ratio was 29.75:1 (p=0.00001). Average age was 26.35+/-8.33 years for men and 37.25+/-14.6 years for women (p=0.01). Seventy eight per cent of patients were aged 11 to 30 years (p=0.00001). Majority were nonsmokers (100/123, p=0.00001). It was first episode of spontaneous pneumothorax for 86 patients. Other 37 patients had 57 episodes previously (mean 1.54+/-0.73; range 1 to 4). INTERVENTIONS: Intercostal tube drainage for all patient with spontaneous pneumothorax. Limited axillary thoracotomy with bullectomy and pleuroabrasion for 32 patients not responding to intercostal tube drainage. RESULTS: Intercostal tube drainage alone had success rate of 90.7% in first, 52.4% in second, 15.4% in third and 0% for more than 3 episodes of spontaneous pneumothorax. Among the 32 patients who underwent surgery, only one had early recurrence that did not require drainage. We found that patients with history of recurrence, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung were more liable to undergo surgical intervention (p=0.00001 for all variables). CONCLUSIONS: We recommend early surgery to hasten recovery and shorten the hospital stay in patients with history of recurrent spontaneous pneumothorax, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung. |
Author | Hamdy, M G Al-Kattan, K M Jain, S K |
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SubjectTerms | Adult Case-Control Studies Chest Tubes Drainage - methods Female Follow-Up Studies Humans Male Pneumothorax - epidemiology Pneumothorax - surgery Pneumothorax - therapy Recurrence Retrospective Studies Thoracostomy Thoracotomy Time Factors |
Title | Spontaneous pneumothorax: determinants of surgical intervention |
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