Korean J Thorac Cardiovasc Surg.  2019 Apr;52(2):85-90. 10.5090/kjtcs.2019.52.2.85.

A Prospective Randomized Trial Comparing Manual Needle Aspiration to Closed Thoracostomy as an Initial Treatment for the First Episode of Primary Spontaneous Pneumothorax

• Kim IH
• Kang DK
• Min HK
• Hwang YH

• KMID: 2447607
• DOI: http://doi.org/10.5090/kjtcs.2019.52.2.85

Abstract

BACKGROUND
Variation exists in the initial treatment for the first episode of primary spontaneous pneumothorax (PSP), and no definitive consensus exists due to a lack of high-quality evidence. This study examined the outcomes of needle aspiration and closed thoracostomy in first episodes of PSP requiring intervention.
METHODS
This study was a randomized, prospective, single-center trial conducted between December 2015 and August 2016. Patients of all ages with a documented first episode of PSP who were unilaterally affected, hemodynamically stable, and had a pneumothorax measuring over 25% in size were included. Patients with underlying lung disease, severe comorbidities, bilateral pneumothorax, tension pneumothorax, recurrent pneumothorax, traumatic pneumothorax, and pregnancy were excluded. Patients were randomly assigned to the needle aspiration or closed thoracostomy group using a random number table.
RESULTS
Forty patients with a first episode of PSP were recruited, and 21 and 19 patients were included in the needle aspiration group and the closed thoracostomy group, respectively. The hospital stay of each group was 2.1±1.8 days and 5.4±3.6 days, respectively (p<0.01). However, no significant differences were found in the success rate of initial treatment or the 1-month and 1-year recurrence rates.
CONCLUSION
Needle aspiration is a favorable initial treatment in patients experiencing a first episode of PSP.

Keyword

Primary spontaneous pneumothorax; Chest aspiration; Thoracostomy

MeSH Terms

Comorbidity
Consensus
Humans
Length of Stay
Lung Diseases
Needles*
Pneumothorax*
Pregnancy
Prospective Studies*
Recurrence
Thoracentesis
Thoracostomy*