2023 Volume 59 Issue 4 Pages 741-746
Purpose: Video-assisted thoracic surgery for spontaneous pneumothorax is widely recognized as one of the standard treatment options. However, there have been few pediatric reports, and its use and indications for nonsurgical treatments (NSTs: drainage or observation) have yet to be established. In this paper, we retrospectively summarize the treatment results of spontaneous pneumothorax at our hospital and verify the treatment policy.
Methods: Medical charts of pneumothorax patients aged two years and older treated at our hospital from 2003 to 2020 were retrospectively reviewed. The patients’ demographics, results of imaging studies, treatments, and outcomes were extracted.
Results: Eighty-seven episodes of pneumothorax in 46 patients were observed. Surgery was performed in 33 episodes (38%) of 21 patients (46%). Recurrence was observed in 9 of 33 episodes (27%) after the surgery and 20 of 54 episodes (37%) after NSTs. Both treatments had a high recurrence rate. The treatments for the first episodes were surgeries for 22 episodes and NSTs for 36 episodes. Of the 36 episodes treated by NSTs, 29 (81%) did not require any surgery during the study period. There was no significant relationship between CT findings and recurrences.
Conclusions: Pediatric surgeons should be aware that their pneumothorax patients tend to have a high recurrence rate of episodes, and more than half of them could be improved by NSTs alone. Thus, NSTs should be given more consideration, and adhesion-inducing procedures should be avoided.
