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Journal of The Korean Society of Emergency Medicine 2003;14(4): 403-408. |
| Comparison of Simple Manual Aspiration and Chest Tube Drainage in the First Occurrence of a Primary Spontaneous Pneumothorax |
| Sang Woo Oh, Sung Youl Hyun, Hyuk Jun Yang, Yong Su Lim, Jae Kwang Kim, Gun Lee |
1Department of Emergency Medicine, Gil Medical Center, Gachon Medical School, Incheon, Korea. yongem@netian.com
2Department of Thoracic & Cardiovascular Surgery, Gil Medical Center, Gachon Medical School, Incheon, Korea. |
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| ABSTRACT |
PURPOSE:
The aim of this prospective study was to determine the safety and the efficacy of simple manual aspiration, as an initial treatment for the first occurrence of a primary spontaneous pneumothorax, as opposed to chest tube drainage.
METHODS:
From January 2002 to December 2002, 98 patients were admitted for the first occurrence of a primary spontaneous pneumothorax. They were divided into 3 groups according to sizes of the pneumothoraces and the treatment modalities: (1) size<25% (n=21; rest and oxygen therapy), (2) 2580% (n=20; chest tube drainage). Fifty-seven patients with pneumothorax size of 25 to 80% were randomly treated with simple manual aspiration (SMA; n=30) or with chest tube drainage (CTD; n=27).
RESULTS:
The therapy was successful in 24 out of 30 patients (80.0%) in the SMA group and in 22 out of 27 patients (81.5%) in the CTD group (p=0.89). The recurrence rates at 3 months for the two groups were similar (6.7% and 11.1%, respectively; p =0.55). The hospital stay was significantly shorter in the SMA group than in the CTD group (4.2+/-3.27 and 7.5+/-2.77 days, respectively; p<0.01). Most of the treatment failures in the SMA group involved pneumothorax sizes greater than 50% (5 out of 6).
CONCLUSION:
This study indicates that simple manual aspiration seems to be as effective and safe as chest tube drainage. Especially, simple manual aspiration may be proposed as a first-line treatment in the first occurrence of a primary spontaneous pneumothorax with a size smaller than 50%. |
| Key words:
Pneumothorax, Treatment, Aspiration |
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