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BTS guidelines for the management of spontaneous pneumothorax
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  • Published on:
    Management of primary and secondary spontaneous pneumothorax

    Dear Editor,

    There is paucity of data with regards to the management of primary and secondary spontaneous pneumothorax.

    A study was conducted to evaluate whether patients with either primary or secondary spontaneous pneumothorax were managed according to current British Thoracic Society guidelines.

    56 consecutive patients with spontaneous pneumothorax were assessed over a 12-month period. In patients with...

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    Conflict of Interest:
    None declared.
  • Published on:
    Primary spontaneous pneumothorax: evidence-based revision of management guidelines

    Dear Editor

    The British Thoracic Society (BTS) guidelines for the management of primary spontaneous pneumothorax (PSP) recommend simple aspiration as the first line treatment for all cases of PSP requiring intervention.[1] However, studies in the UK have shown that compliance is poor, and that simple aspiration is under-utilised.[2,3] Henry et al suggested that poor compliance may be due to an unwillingness to...

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    Conflict of Interest:
    None declared.
  • Published on:
    Response to Dr Chan
    • Michael T Henry, Consultant Respiratory Physician
    • Other Contributors:
      • John Harvey, Anthony Arnold

    Dear Editor

    We thank Dr Chan for his further reponse 'error in citation' to the recently published BTS guidelines for the management of spontaneous pneumothorax.[1] Dr Chan has pointed out that our statement in a previous correspondence to him, that a 2cms rim of pneumothorax was a clear indication for use of an intercostal chest drain, was supported by the recent ACCP Delphi consensus document [2] is a error in...

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    Conflict of Interest:
    None declared.
  • Published on:
    Reply to Dr Ng
    • Michael T Henry, Consultant Respiratory Physician
    • Other Contributors:
      • Tony Arnold, John Harvey

    Dear Editor

    We thank Dr Ng for his comments on the recently published guidelines on the management of spontaneous pneumothorax.[1] Dr Ng points out that recurrence rates for pneumothorax after VATS preventative procedures were lower than those quoted in the guidelines. It should be pointed out that in the multiple drafts of this document, it was recognised that recurrence rates after VATs were falling and that f...

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    Conflict of Interest:
    None declared.
  • Published on:
    Reference for evidence: error in citation?

    Dear Editor

    I am grateful for Dr Henry's reply and further comments on 4 September, 2003.[1] Dr Henry stated that the use of '2 cm' correlating to '50%' as an indication for chest tube drainage in secondary spontaneous pneumothorax was supported by evidence, and that this had become a clear and unambiguous guideline. However, the evidence cited [2] was a 'consensus statement' by the American College of Chest Physici...

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    Conflict of Interest:
    None declared.
  • Published on:
    Author's Reply
    • Michael T Henry, Consultant Respiratory Physician
    • Other Contributors:
      • Tony Arnold, John Harvey

    Dear Editor

    We thank Dr Chan for his comments relating to the recently published guidelines for the diagnosis and management of spontaneous pneumothorces.[1] Dr Chan raises the contentious issue of estimation of the size of a pneumothorax from a plain chest radiograph. We have attempted to use a variation of the method of Axel based on the largest distance from the chest wall to the pleural line and using the assum...

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    Conflict of Interest:
    None declared.
  • Published on:
    Paradigm shift in surgical approaches to spontaneous pneumothorax: VATS
    • Dr. Calvin S.H. Ng, Cardiothoracic Surgeon
    • Other Contributors:
      • Dr. Song Wan, Professor Anthony P.C. Yim

    Dear Editor

    "It is not the strongest of the species that survives, nor the most intelligent, it is the one most adaptable to change."
    Charles Darwin (1809-1882)

    The article "BTS guidelines for the management of spontaneous pneumothorax" by Henry et al.[1] has recently stimulated some discussion among our respiratory physicians and thoracic surgeons.

    We found it in...

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    Conflict of Interest:
    None declared.
  • Published on:
    Estimation of size of pneumothorax under the new BTS guidelines

    Dear Editor

    I read, with interest, the new BTS guidelines for the management of spontaneous pneumothorax.[1] Arnold and colleagues acknowledged that the plain radiograph was a poor method of quantifying the size of a pneumothorax, yet then went on to use one radiographic method of assessment to estimate the degree of lung collapse.

    Under the new guidelines, the size of a pneumothorax is divided into "...

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    Conflict of Interest:
    None declared.