Conservative Treatment Approach in Primary Spontaneous Pneumothorax

Abstract

Objective: To evaluate the efficacy and pain levels of minimally invasive approaches in the treatment of primary spontaneous pneumothorax (PSP).

Study design: Observational study Place and Duration of Study: Department of Thoracic Surgery, Balikesir University, Turkey, from August 2017 to August 2019.

Methodology: Patients with primary spontaneous pneumothorax aged over 18 years, hospitalised in the thoracic surgery department, and treated with conservative and minimally invasive approaches were included in the study. These approaches included continuous oxygen inhalation and small bore thorax catheter drainage. Patients were evaluated for age, gender, pneumothorax level, treatment modality, duration of discharge and recurrence. The obtained data were analysed statistically.

Results: A total of 80 patients (76 males, 4 females) had a mean age of 28.8 ±9.47 years. While 24 (30%) of the patients were treated conservatively, 56 patients (70%) underwent drainage with 8 F thorax catheter. Two patients who had conservative treatment primarily, later underwent drainage with an 8 F thorax catheter due to the lack of response to treatment. One patient underwent videothoraco-scopic bulla excision and partial parietal pleurectomy because of the nonexpandable lung. The average length of hospital stay was 3.55 ±1.41 days.

Conclusion: Conservative treatment and treatment with small catheters are effective approaches in spontaneous pneumothorax patients. Patients with PSP should be managed first with minimally invasive approaches.