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Children with large primary spontaneous pneumothoraxes may benefit from early operative intervention.
- Source :
-
Pediatric surgery international [Pediatr Surg Int] 2022 Mar; Vol. 38 (3), pp. 423-429. Date of Electronic Publication: 2022 Jan 25. - Publication Year :
- 2022
-
Abstract
- Purpose: The initial management of primary spontaneous pneumothoraxes (PSP) in children remains controversial, particularly regarding the timing of operative intervention. This study aimed to identify factors associated with failure of non-operative management of PSP.<br />Methods: A single-center, retrospective review was performed for patients presenting with PSP. Demographics and clinical predictors were collected. Patients successfully managed non-operatively were compared to failed non-operative management. Fischer exact and Mann-Whitney tests were used as appropriate.<br />Results: Fifty-seven pediatric patients were identified as having PSP. Four patients underwent initial surgical intervention, 60% (n = 34) were successfully managed non-operatively, while 33% (n = 19) failed non-operative management and underwent video-assisted thoracic surgery (VATS). Those who failed were more likely to have PSP > 2 cm on initial X-ray (79% vs. 44%, p = 0.021) and have a persistent air leak for > 48 h (47% vs 6%, p ≤ 0.001). LOS was greater in the failure group (11.5 ± 5.1 vs 3.1 ± 2.5, p ≤ 0.001) as well as higher complication rates (21% vs 0%, p = 0.013).<br />Conclusion: Our findings suggest that patients presenting with PSP of > 2 cm or have a persistent air leak for > 48 h despite chest tube management are unlikely to be treated by chest tube alone and may benefit from earlier operative intervention.<br /> (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Details
- Language :
- English
- ISSN :
- 1437-9813
- Volume :
- 38
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Pediatric surgery international
- Publication Type :
- Academic Journal
- Accession number :
- 35076755
- Full Text :
- https://doi.org/10.1007/s00383-022-05068-4