[Different approaches to chest drainage in the management of primary spontaneous pneumothorax]

Rev Mal Respir. 2019 Apr;36(4):477-483. doi: 10.1016/j.rmr.2019.01.007. Epub 2019 Apr 17.
[Article in French]

Abstract

Drainage of primary spontaneous pneumothorax (PSP) may be managed by different techniques and with different types of drain. It is mainly performed in the pneumology department or in the emergency department. The aim of the study was to evaluate the factors that influence the success of PSP drainage. This retrospective, monocentric study performed in University Hospital of Toulouse, included patients with a first episode of PSP requiring drainage. The primary outcome was the rate of success according to the techniques of drainage. Data on the size of the drain (>14F or<14F), the drainage technique (small bore catheter or chest tube drainage) and the drainage department (pneumology or emergency) were collected. One hundred and twenty-four patients had a drainage between 2014 and 2016: the late recurrence free success rate was 59% (n=73). Compared with emergency, drainage in pneumology increased the success rate threefold regardless of the drainage technique (P=0.0001) The success rate was similar whatever the technique used (Seldinger or classic technique) (P=0.31). Success and complications rates were similar whether the drain was large (>14F) or small (<14F) (respectively P=0.99 and P=0.58). In our study, the drainage of PSP in the pneumology department, with a small caliber inserted by the Seldinger technique, was associated with a significantly higher success rate.

Keywords: Chest tube; Drain pleural; Emergency medical service; Pneumologie; Pneumology; Pneumothorax spontané; Seldinger; Seldinger, Services des urgences; Spontaneous pneumothorax.

MeSH terms

  • Adult
  • Chest Tubes / adverse effects
  • Chest Tubes / statistics & numerical data
  • Drainage / adverse effects
  • Drainage / instrumentation
  • Drainage / methods*
  • Equipment Design / adverse effects
  • Equipment Design / statistics & numerical data
  • Female
  • Humans
  • Male
  • Pneumothorax / diagnosis*
  • Pneumothorax / epidemiology
  • Pneumothorax / pathology
  • Pneumothorax / therapy*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prognosis
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Thoracentesis / adverse effects
  • Thoracentesis / instrumentation
  • Thoracentesis / methods
  • Treatment Outcome
  • Young Adult