Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Apr 6;18(1):105.
doi: 10.1186/s13019-023-02207-3.

Pleural abrasion versus apical pleurectomy for primary spontaneous pneumothorax: a systematic review and Meta-analysis

Jaewon Chang  1 , Vignesh Ratnaraj  2 , Vincent Fu  3 , Michael Jiang  4 , Varun Peri  4 , Minhtuan Nguyenhuy  5 , Phillip Antippa  2
Affiliations
Meta-Analysis

Pleural abrasion versus apical pleurectomy for primary spontaneous pneumothorax: a systematic review and Meta-analysis

Jaewon Chang et al. J Cardiothorac Surg. .

Abstract

Background: Surgical approach is the most effective treatment for primary spontaneous pneumothorax. The two most widely adopted surgical methods are mechanical abrasion and apical pleurectomy, in addition to bullectomy. We performed a systematic review and meta-analysis to examine which technique is superior in treating primary spontaneous pneumothorax.

Methods: PubMed, MEDLINE and EMBASE databases were searched for studies published between January 2000 to September 2022 comparing mechanical abrasion and apical pleurectomy for treatment of primary spontaneous pneumothorax. The primary outcome was pneumothorax recurrence. Secondary outcomes included post-operative chest tube duration, hospital length of stay, operative time and intra-operative of blood loss.

Results: Eight studies were eligible for inclusion involving 1,613 patients. There was no difference in the rate of pneumothorax recurrence between pleural abrasion and pleurectomy (RR: 1.34; 95% CI: 0.94 to 1.92). However, pleural abrasion led to shorter hospital length of stay (MD: -0.25; 95% CI: -0.51 to 0.00), post-operative chest tube duration (MD: -0.30; 95% CI: -0.56 to -0.03), operative time (MD: -13.00; 95% CI -15.07 to 10.92) and less surgical blood loss (MD: -17.77; 95% CI: -24.36 to -11.18).

Conclusion: Pleural abrasion leads to less perioperative patient burden and shorter hospital length of stay without compromising the rate of pneumothorax recurrence when compared to pleurectomy. Thus, pleural abrasion is a reasonable first choice surgical procedure for management of primary spontaneous pneumothorax.

Keywords: Pleural abrasion; Pleurectomy; Pleurodesis; Primary spontaneous pneumothorax.

PubMed Disclaimer

Conflict of interest statement

Authors have no competing interests to declare.

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRIMSA flowchart
Fig. 2
Fig. 2
Forest plot displaying relative risk (RR) of pneumothorax recurrence rate post pleurodesis with pleural abrasion and pleurectomy
Fig. 3
Fig. 3
Forest plot displaying mean difference (MD) of mean hospital length of stay and chest tube duration between pleural abrasion and pleurectomy
Fig. 4
Fig. 4
Forest plot displaying mean difference (MD) of mean operation time between pleural abrasion and pleurectomy
Fig. 5
Fig. 5
Forest plot displaying mean difference (MD) of mean blood loss between pleural abrasion and pleurectomy
See this image and copyright information in PMC

References

    1. Wong A, Galiabovitch E, Bhagwat K. Management of primary spontaneous pneumothorax: a review. ANZ J Surg. 2019;89(4):303–8. doi: 10.1111/ans.14713. - DOI - PubMed
    1. Mendogni P, Vannucci J, Ghisalberti M, Anile M, Aramini B, Congedo MT, et al. Epidemiology and management of primary spontaneous pneumothorax: a systematic review. Interact Cardiovasc Thorac Surg. 2020;30(3):337–45. doi: 10.1093/icvts/ivz290. - DOI - PubMed
    1. Bobbio A, Dechartres A, Bouam S, Damotte D, Rabbat A, Regnard JF, et al. Epidemiology of spontaneous pneumothorax: gender-related differences. Thorax. 2015;70(7):653–8. doi: 10.1136/thoraxjnl-2014-206577. - DOI - PubMed
    1. Tabakoglu E, Ciftci S, Hatipoglu ON, Altiay G, Caglar T. Levels of superoxide dismutase and malondialdehyde in primary spontaneous pneumothorax. Mediators Inflamm. 2004;13(3):209–10. doi: 10.1080/09511920410001713475. - DOI - PMC - PubMed
    1. Ling ZG, Wu YB, Ming MY, Cai SQ, Chen YQ. The effect of pleural abrasion on the treatment of primary spontaneous pneumothorax: a systematic review of randomized controlled trials. PLoS ONE. 2015;10(6):e0127857. doi: 10.1371/journal.pone.0127857. - DOI - PMC - PubMed