Dov Weissberg, MD, FCCP and Yael Refaely, MD
* From the Department of Thoracic Surgery (Dr. Rafaely), Tel Aviv University Sackler School of Medicine, Tel Aviv; and E. Wolfson Medical Center (Dr. Weissberg), Holon, Israel.
Correspondence to: Dov Weissberg, MD, FCCP, E. Wolfson Medical Center, Holon 58100, Israel.
To study the outcome of pneumothorax managed in a university-affiliated metropolitan medical center.
A retrospective review.
Busy metropolitan medical center.
Patients and methods: Records of 1,199 patients with pneumothorax were reviewed and analyzed.
Primary spontaneous pneumothorax occurred in 218 patients, secondary spontaneous pneumothorax occurred in 505, traumatic in 403, and iatrogenic in 73. Ninety-six patients with small pneumothorax (8%) were managed by observation, and 1,103 patients (92%) were managed by tube thoracostomy. Drainage of the pleural cavity was continued for 1 to 7 days in 893 patients (81%), 8 to 10 days in 176 patients (16%), and >]]]] 10 days in 34 patients (3%). Drainage for >]]]] 10 days was classified as persistent pneumothorax. In these 34 patients and in 132 others with a second ipsilateral recurrence (a total of 166 patients), direct pleuroscopy was performed. The pleuroscopy findings and further management are outlined in the algorithm.
Pneumothorax is a common condition affecting all age groups. If the volume of the pneumothorax is >]]]] 20% of the pleural space, pleural drainage is indicated. For management of persistent or recurrent pneumothorax, the use of pleuroscopy (direct or video-assisted) is of great value and should be part of routine management.
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