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Meta-Analysis
. 2021 Apr 30;16(4):e0250929.
doi: 10.1371/journal.pone.0250929. eCollection 2021.

Systematic review and meta-analysis on juvenile primary spontaneous pneumothorax: Conservative or surgical approach first?

Chun-Shan Hung  1 , Yang-Ching Chen  2   3 , Ten-Fang Yang  4   5 , Fu-Huan Huang  4   6
Affiliations
Meta-Analysis

Systematic review and meta-analysis on juvenile primary spontaneous pneumothorax: Conservative or surgical approach first?

Chun-Shan Hung et al. PLoS One. .

Abstract

Background: Primary spontaneous pneumothorax (PSP) prevalence is typically higher in juvenile patients than in adults. We aimed to evaluate the optimal treatment for primary spontaneous pneumothorax and its efficacy and safety in juveniles.

Materials and methods: We searched PubMed, Embase, and Cochrane databases for eligible studies published from database inception to October 10, 2020, and conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary and secondary outcomes were recurrence rate and hospital stay length, respectively. Odds ratios (OR) and mean differences were used for quantitatively analyzing binary and continuous outcomes, respectively. In total, nine retrospective studies with 1,452 juvenile patients (aged <21) were included for the quantitative analysis. The surgical approach led to a lower recurrence rate than did conservative approaches (OR: 1.95, 95% confidence interval: 1.15-3.32). Moreover, the recurrence rate was low in patients who underwent conservative treatment first and received surgery later.

Conclusions: Surgical approach for first-line management might have a greater effect on recurrence prevention than do conservative approaches. An upfront surgery might be an optimal choice for juvenile primary spontaneous pneumothorax.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart.
Fig 2
Fig 2. Recurrence rate of conservative approaches versus surgical approach as first-line management.
Fig 3
Fig 3. Recurrence rate of conservative approaches only versus surgical approach after initial conservative approaches.
Fig 4
Fig 4. Length of hospital stay.
Fig 5
Fig 5. Publication bias.
See this image and copyright information in PMC

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