Abstract
We assessed the use of a pleural catheter (Thoracic Vent: a small device for the treatment of simple pneumothorax) to determine its effectiveness in treating spontaneous pneumothorax for outpatient management.
Sixty-three pneumothorax patients were treated using a thoracic vent in a 12 month period at our hospital. There were 54 men and 9 women with a mean age of 31.9 years (range, 16 to 76 years). Forty-two patients were first pneumothorax, and 21 were recurrent pneumothorax. Outpatient treatment was successful in 30 cases (71.4 %) of 42 first pneumothorax patients. Four patients were hospitalized on the first day because of massive air leakage in 2, and initial cases in 2. The other 8 patients were hospitalized and underwent thoracoscopic surgery because of persistent air leakage in 6, giant bulla in 1, and a history of contralateral pneumoth orax in 1. Our indication for operation is persistent air leakage (7 days or more) and recurrent pneumothorax. Eighteen of 21 recurrent pneumothorax patients underwent operation, the majority of whom were treated using thoracic vent as outpatients until admission. In the present series, outpatient management saved a total of 291 inpatient days.
Continuous suction of the thoracic vent was needed in 4 patients, 2 of whom required second drainage tubes because of obstruction by pleural effusion in one and massive air leakage in the other. No kinks in the catheter or accidental removal of the thoracic vent were encountered. No serious complications occurred, except for mild reexpansive pulmonary edema in one case.
The thoracic vent is useful in the outpatient management of spontaneous pneumothorax.
