Chest
Clinical Investigations; Articles; Thoracic SurgerySpontaneous Pneumothorax: Comparison of Thoracic Drainage vs Immediate or Delayed Needle Aspiration
Section snippets
Patients
Patients older than 18 years were considered for the present study if they were suffering from a first episode or first recurrence of a complete SP. Patients were not included when presenting any of the following: posttraumatic, iatrogenic, or bilateral pneumothorax; third ipsilateral episode or more; moderate-to-major associated pleural effusion or hemothorax; contralateral emphysematous bullae; suspected or proven lung cancer, lung abscess, or consolidated pneumonia; diffuse interstitial
First Protocol
Sixty-one patients were included in this protocol, 33 of them randomized to NA and 28 to TD. Some relevant clinical data for these two populations are depicted in Table 1. There were no significant differences between these two groups.
Short-term Efficacy of Therapy: Twenty-two and 26 patients were successfully treated with NA alone and with TD, respectively. This led to a significantly higher success rate for TD when compared with NA (93%, CI 84 to 100%, vs 67%, CI 51 to 83%; p=0.01). Nine of
Discussion
The present prospective study addressed three important issues concerning medical treatment of SP, namely short-term efficacy of NA vs TD, timing of NA (ie, immediate vs delayed thoracocentesis), and recurrence rates with both techniques.
In the randomized part of the trial, we observed that TD via a chest tube was significantly more effective in the treatment of pneumothorax than NA via a small-caliber plastic needle. It must be noted, however, that criteria for TD failure were far more
ACKNOWLEDGMENTS
The authors are indebted to Drs. Emmanuel Antoni and Kaï Kollenbach for their personal contribution in the realization of the study, and to Dr. Pierre Aslanian for his expert review of the manuscript.
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This work has been presented in part at the conference of the American Thoracic Society, Anaheim, Calif, May 12-15, 1991.