Full Text:   <3256>

CLC number: R56

On-line Access: 2010-10-05

Received: 2010-04-08

Revision Accepted: 2010-05-16

Crosschecked: 2010-09-02

Cited: 22

Clicked: 6456

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2010 Vol.11 No.10 P.735-744

http://doi.org/10.1631/jzus.B1000131


Diagnosis and treatment of primary spontaneous pneumothorax


Author(s):  Shi-ping Luh

Affiliation(s):  Department of Surgery, St. Martin de Porres Hospital, Chia-Yi City 60069, Taiwan, China

Corresponding email(s):   luh572001@yahoo.com.tw

Key Words:  Primary spontaneous pneumothorax (PSP), Diagnosis, Treatment


Share this article to: More |Next Article >>>

Shi-ping Luh. Diagnosis and treatment of primary spontaneous pneumothorax[J]. Journal of Zhejiang University Science B, 2010, 11(10): 735-744.

@article{title="Diagnosis and treatment of primary spontaneous pneumothorax",
author="Shi-ping Luh",
journal="Journal of Zhejiang University Science B",
volume="11",
number="10",
pages="735-744",
year="2010",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1000131"
}

%0 Journal Article
%T Diagnosis and treatment of primary spontaneous pneumothorax
%A Shi-ping Luh
%J Journal of Zhejiang University SCIENCE B
%V 11
%N 10
%P 735-744
%@ 1673-1581
%D 2010
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1000131

TY - JOUR
T1 - Diagnosis and treatment of primary spontaneous pneumothorax
A1 - Shi-ping Luh
J0 - Journal of Zhejiang University Science B
VL - 11
IS - 10
SP - 735
EP - 744
%@ 1673-1581
Y1 - 2010
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1000131


Abstract: 
primary spontaneous pneumothorax (PSP) commonly occurs in tall, thin, adolescent men. Though the pathogenesis of PSP has been gradually uncovered, there is still a lack of consensus in the diagnostic approach and treatment strategies for this disorder. Herein, the literature is reviewed concerning mechanisms and personal clinical experience with PSP. The chest computed tomography (CT) has been more commonly used than before to help understand the pathogenesis of PSP and plan further management strategies. The development of video-assisted thoracoscopic surgery (VATS) has changed the profiles of management strategies of PSP due to its minimal invasiveness and high effectiveness for patients with these diseases.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Abdala, O.A., Levy, R.R., Bibiloni, R.H., Viso, H.D., de Souza, M., Satler, V.H., 2001. Advantages of video assisted thoracic surgery in the treatment of spontaneous pneumothorax. Medicina (B Aires), 61(2):157-160.

[2]Al-Qudah, A., 2006. Treatment options of spontaneous pneumothorax. Indian J. Chest Dis. Allied Sci., 48(3):191-200.

[3]Alifano, M., Forti Parri, S.N., Bonfanti, B., Arab, W.A., Passini, A., Boaron, M., Roche, N., 2007. Atmospheric pressure influences the risk of pneumothorax: beware of the storm! Chest, 131(6):1877-1882.

[4]Amjadi, K., Alvarez, G.G., Vanderhelst, E., Velkeniers, B., Lam, M., Noppen, M., 2007. The prevalence of blebs or bullae among young healthy adults: a thoracoscopic investigation. Chest, 132(4):1140-1145.

[5]Barker, A., Maratos, E.C., Edmonds, L., Lim, E., 2007. Recurrence rates of video-assisted thoracoscopic versus open surgery in the prevention of recurrent pneumothoraces: a systematic review of randomised and non-randomised trials. Lancet, 370(9584):329-335.

[6]Baumann, M.H., 2003. What size chest tube? What drainage system is ideal? And other chest tube management questions. Curr. Opin. Pulm. Med., 9(4):276-281.

[7]Baumann, M.H., Strange, C., 1997. Treatment of spontaneous pneumothorax: a more aggressive approach? Chest, 112(3):789-804.

[8]Ben-Nun, A., Soudack, M., Best, L.A., 2006. Video-assisted thoracoscopic surgery for recurrent spontaneous pneumothorax: the long-term benefit. World J. Surg., 30(3):285-290.

[9]Bense, L., Eklund, G., Wiman, L.G., 1987. Smoking and the increased risk of contracting spontaneous pneumothorax. Chest, 92(6):1009-1012.

[10]Bertrand, P.C., Regnard, J.F., Spaggiari, L., Levi, J.F., Magdeleinat, P., Guibert, L., Levasseur, P., 1996. Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Ann. Thorac. Surg., 61(6):1641-1645.

[11]Bialas, R.C., Weiner, T.M., Phillips, J.D., 2008. Video-assisted thoracic surgery for primary spontaneous pneumothorax in children: is there an optimal technique? J. Pediatr. Surg., 43(12):2151-2155.

[12]Birrer, R.B., Calderon, J., 1984. Pneumothorax, pneumomediastinum, and pneumopericardium following Valsalva’s maneuver during marijuana smoking. N. Y. State J. Med., 84(12):619-620.

[13]Bradley, M., Williams, C., Walshaw, M.J., 1991. The value of routine expiratory chest films in the diagnosis of pneumothorax. Arch. Emerg. Med., 8(2):115-116.

[14]Cardillo, G., Facciolo, F., Regal, M., Carbone, L., Corzani, F., Ricci, A., Martelli, M., 2001. Recurrences following videothoracoscopic treatment of primary spontaneous pneumothorax: the role of redo-videothoracoscopy. Eur. J. Cardiothorac. Surg., 19(4):396-399.

[15]Chambers, A., Scarci, M., 2009. In patients with first-episode primary spontaneous pneumothorax is video-assisted thoracoscopic surgery superior to tube thoracostomy alone in terms of time to resolution of pneumothorax and incidence of recurrence? Interact. Cardiovasc. Thorac. Surg., 9(6):1003-1008.

[16]Chen, J.S., Hsu, H.H., Kuo, S.W., Tsai, P.R., Chen, R.J., Lee, J.M., Lee, Y.C., 2004. Effects of additional minocycline pleurodesis after thoracoscopic procedures for primary spontaneous pneumothorax. Chest, 125(1):50-55.

[17]Chen, J.S., Hsu, H.H., Chen, R.J., Kuo, S.W., Huang, P.M., Tsai, P.R., Lee, J.M., Lee, Y.C., 2006. Additional minocycline pleurodesis after thoracoscopic surgery for primary spontaneous pneumothorax. Am. J. Respir. Crit. Care Med., 173(5):548-554.

[18]Chen, J.S., Hsu, H.H., Tsai, K.T., Yuan, A., Chen, W.J., Lee, Y.C., 2008. Salvage for unsuccessful aspiration of primary pneumothorax: thoracoscopic surgery or chest tube drainage? Ann. Thorac. Surg., 85(6):1908-1913.

[19]Chen, Y.J., Luh, S.P., Hsu, K.Y., Chen, C.R., Tsao, T.C., Chen, J.Y., 2008. Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax. J. Zhejiang Univ.-Sci. B, 9(4):335-340.

[20]Cheng, Y.L., Huang, T.W., Lin, C.K., Lee, S.C., Tzao, C., Chen, J.C., Chang, H., 2009. The impact of smoking in primary spontaneous pneumothorax. J. Thorac. Cardiovasc. Surg., 138(1):192-195.

[21]Chou, S.H., Li, H.P., Lee, J.Y., Chang, S.J., Lee, Y.L., Chang, Y.T., Kao, E.L., Dai, Z.K., Huang, M.F., 2010. Is prophylactic treatment of contralateral blebs in patients with primary spontaneous pneumothorax indicated? J. Thorac. Cardiovasc. Surg., 139(5):1241-1245.

[22]Choudhary, A.K., Sellars, M.E., Wallis, C., Cohen, G., McHugh, K., 2005. Primary spontaneous pneumothorax in children: the role of CT in guiding management. Clin. Radiol., 60(4):508-511.

[23]Cook, C.H., Melvin, W.S., Groner, J.I., Allen, E., King, D.R., 1999. A cost-effective thoracoscopic treatment strategy for pediatric spontaneous pneumothorax. Surg. Endosc., 13(12):1208-1210.

[24]Cottrell, G.P., 2003. Cardiopulmonary Anatomy and Physiology for Respiratory Care Practitioners. Davis Co., Philadelphia, FA.

[25]de Perrot, M., Deleaval, J., Robert, J., Spiliopoulos, A., 2000. Spontaneous hemopneumothorax-results of conservative treatment. Swiss Surg., 6(2):62-64.

[26]Gigirey Castro, O., Berlanga González, L., Sánchez Gómez, E., 2010. Single port thorascopic surgery using the SILS® tool as a novel method in the surgical treatment of pneumothorax. Arch. Bronconeumol., 46(8):439-441 (in Spanish).

[27]Gossot, D., Galetta, D., Stern, J.B., Debrosse, D., Caliandro, R., Girard, P., Grunenwald, D., 2004. Results of thoracoscopic pleural abrasion for primary spontaneous pneumothorax. Surg. Endosc., 18(3):466-471.

[28]Graham, R.B., Nolasco, M., Peterlin, B., Garcia, C.K., 2005. Nonsense mutations in folliculin presenting as isolated familial spontaneous pneumothorax in adults. Am. J. Respir. Crit. Care Med., 172(1):39-44.

[29]Guimaraes, C.V., Donnelly, L.F., Warner, B.W., 2007. CT findings for blebs and bullae in children with spontaneous pneumothorax and comparison with findings in normal age-matched controls. Pediatr. Radiol., 37(9):879-884.

[30]Hart, S.R., Willis, C., Thorn, A., Barfoot, L., 2002. Spontaneous haemopneumothorax: are guidelines overdue? Emerg. Med. J., 19(3):273-274.

[31]Horio, H., Nomori, H., Kobayashi, R., Naruke, T., Suemasu, K., 2002. Impact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax. Surg. Endosc., 16(4):630-634.

[32]Hsiao, C.W., Lee, S.C., Tzao, C., Chen, J.C., Cheng, Y.L., 2003. Minithoracotomy with simultaneous video-assisted thoracoscopic surgery vs. video-assisted thoracoscopic surgery for spontaneous hemopneumothorax. Thorac. Cardiovasc. Surg., 51(5):288-290.

[33]Hsu, N.Y., Shih, C.S., Hsu, C.P., Chen, P.R., 2005. Spontaneous hemopneumothorax revisited: clinical approach and systemic review of the literature. Ann. Thorac. Surg., 80(5):1859-1863.

[34]Huang, T.W., Lee, S.C., Cheng, Y.L., Tzao, C., Hsu, H.H., Chang, H., Chen, J.C., 2007. Contralateral recurrence of primary spontaneous pneumothorax. Chest, 132(4):1146-1150.

[35]Hunt, I., Barber, B., Southon, R., Treasure, T., 2007. Is talc pleurodesis safe for young patients following primary spontaneous pneumothorax? Interact. Cardiovasc. Thorac. Surg., 6(1):117-120.

[36]Ikeda, M., Uno, A., Yamane, Y., Hagiwara, N., 1988. Median sternotomy with bilateral bullous resection for unilateral spontaneous pneumothorax, with special reference to operative indications. J. Thorac. Cardiovasc. Surg., 96(4):615-620.

[37]Jordan, K.G., Kwong, J.S., Flint, J., Muller, N.L., 1997. Surgically treated pneumothorax. Radiologic, pathologic findings. Chest, 111(2):280-285.

[38]Jutley, R.S., Khalil, M.W., Rocco, G., 2005. Uniportal vs. standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur. J. Cardiothorac. Surg., 28(1):43-46.

[39]Kelly, A.M., 2009. Treatment of primary spontaneous pneumothorax. Curr. Opin. Pulm. Med., 15(4):376-379.

[40]Klopp, M., Dienemann, H., Hoffmann, H., 2007. Treatment of pneumothorax. Der Chirurg, 78(7):655-668.

[41]Lang-Lazdunski, L., Chapuis, O., Bonnet, P.M., Pons, F., Jancovici, R., 2003. Videothoracoscopic bleb excision, pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term results. Ann. Thorac. Surg., 75(3):960-965.

[42]Light, R.W., 1990. Pleural Diseases. Lea & Febiger, Philadelphia.

[43]Liu, H.P., Yim, A.P., Izzat, M.B., Lin, P.J., Chang, C.H., 1999. Thoracoscopic surgery for spontaneous pneumothorax. World J. Surg., 23(11):1133-1136.

[44]Luh, S.P., Liu, H.P., 2006. Video-assisted thoracic surgery— the past, present status, the future. J. Zhejiang Univ.-Sci. B, 7(2):118-128.

[45]Luh, S.P., Tsao, T.C., 2007. Video-assisted thoracic surgery for spontaneous haemopneumothorax. Respirology, 12(3):443-447.

[46]Luh, S.P., Lee, Y.C., Lee, J.M., Lee, C.J., 1996. Videothoracoscopic treatment of spontaneous pneumothorax. Int. Surg., 81(4):336-338.

[47]Luh, S.P., Koon, W.J., Su, M.S., Yang, C.C., Lee, Y.C., 1998. Videothoracoscopic diagnosis, treatment of pulmonary lymphangio leiomyomatosis (PLAM) with recurrent pneumothorax. J. Surg. Assoc. ROC, 31:251-255.

[48]Luh, S.P., Tsai, T.P., Chou, M.C., Yang, P.C., Lee, C.J., 2004. Video-assisted thoracic surgery for spontaneous pneumothorax: outcome of 189 cases. Int. Surg., 89(4):185-189.

[49]Martinez-Ramos, D., Angel-Yepes, V., Escrig-Sos, J., Miralles-Tena, J.M., Salvador-Sanchis, J.L., 2007. Usefulness of computed tomography in determining risk of recurrence after a first episode of primary spontaneous pneumothorax: therapeutic implications. Arch. Bronconeumol., 43(6):304-308.

[50]Mitlehner, W., Friedrich, M., Dissmann, W., 1992. Value of computer tomography in the detection of bullae, blebs in patients with primary spontaneous pneumothorax. Respiration, 59(4):221-227.

[51]Miyazawa, M., Fujita, T., Misawa, R., Sakai, T., Toishi, M., Koyama, H., Hyougotani, A., Haba, Y., Kato, K., Muramatsu, A., 2002. Thoracoscopic treatment for spontaneous hemopneumothorax. Surg. Endosc., 16(7):1106.

[52]Morimoto, T., Fukui, T., Koyama, H., Noguchi, Y., Shimbo, T., 2002. Optimal strategy for the first episode of primary spontaneous pneumothorax in young men. A decision analysis. J. Gen. Intern. Med., 17(3):193-202.

[53]Mukaida, T., Andou, A., Date, H., Aoe, M., Shimizu, N., 1998. Thoracoscopic operation for secondary pneumothorax under local and epidural anesthesia in high-risk patients. Ann. Thorac. Surg., 65(4):924-926.

[54]Noppen, M., de Keukeleire, T., 2008. Pneumothorax. Respiration, 76(2):121-127.

[55]Noppen, M., Alexander, P., Driesen, P., Slabbynck, H., Verstraete, A., 2001. Quantification of the size of primary spontaneous pneumothorax: accuracy of the light index. Respiration, 68(4):396-399.

[56]Noppen, M., Verbanck, S., Harvey, J., van Herreweghe, R., Meysman, M., Vincken, W., Paiva, M., 2004. Music: a new cause of primary spontaneous pneumothorax. Thorax, 59(8):722-724.

[57]Ohata, M., Suzuki, H., 1980. Pathogenesis of spontaneous pneumothorax. With special reference to the ultrastructure of emphysematous bullae. Chest, 77(6):771-776.

[58]Olavarrieta, J.R., Coronel, P., 2009. Expectations, patient satisfaction related to the use of thoracotomy, video-assisted thoracoscopic surgery for treating recurrence of spontaneous primary pneumothorax. J. Bras. Pneumol., 35(2):122-128.

[59]Oransky, I., 2007. Long-term follow-up of thoracoscopic talc pleurodesis for primary spontaneous pneumothorax. Eur. Respir. J., 30(3):598.

[60]Ouanes-Besbes, L., Golli, M., Knani, J., Dachraoui, F., Nciri, N., El Atrous, S., Gannouni, A., Abroug, F., 2007. Prediction of recurrent spontaneous pneumothorax: CT scan findings versus management features. Respir. Med., 101(2):230-236.

[61]Pompeo, E., Tacconi, F., Mineo, D., Mineo, T.C., 2007. The role of awake video-assisted thoracoscopic surgery in spontaneous pneumothorax. J. Thorac. Cardiovasc. Surg., 133(3):786-790.

[62]Qureshi, F.G., Sandulache, V.C., Richardson, W., Ergun, O., Ford, H.R., Hackam, D.J., 2005. Primary vs. delayed surgery for spontaneous pneumothorax in children: which is better? J. Pediatr. Surg., 40(1):166-169.

[63]Robinson, P.D., Cooper, P., Ranganathan, S.C., 2009. Evidence-based management of paediatric primary spontaneous pneumothorax. Paediatr. Respir. Rev., 10(3):110-117.

[64]Roman, M., Weinstein, A., Macaluso, S., 2003. Primary spontaneous pneumothorax. Medsurg. Nurs., 12(3):161-169.

[65]Sahn, S.A., Heffner, J.E., 2000. Spontaneous pneumothorax. N. Engl. J. Med., 342(12):868-874.

[66]Sasai, T., Shioda, M., 1995. Treatment, etiology of spontaneous hemopneumothorax. Kyobu Geka, 48(4):337-339.

[67]Sawada, S., Watanabe, Y., Moriyama, S., 2005. Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: evaluation of indications, long-term outcome compared with conservative treatment, open thoracotomy. Chest, 127(6):2226-2230.

[68]Schmidt-Horlohe, N., Rudig, L., Azvedo, C.T., Habekost, M., 2008. Fulminant unilateral pulmonary edema after insertion of a chest tube: a complication after a primary spontaneous pneumothorax. Dtsch. Arztebl. Int., 105(50):878-881.

[69]Sedrakyan, A., van der Meulen, J., Lewsey, J., Treasure, T., 2004. Video assisted thoracic surgery for treatment of pneumothorax, lung resections: systematic review of randomised clinical trials. BMJ, 329(7473):1008.

[70]Sharpe, D.A., Dixon, K., Moghissi, K., 1995. Spontaneous haemopneumothorax: a surgical emergency. Eur. Respir. J., 8(9):1611-1612.

[71]Shields, T.W., Locicero, J., Ponn, R.B., Rusch, V.W., 2005. General Thoracic Surgery. Lippincott Williams & Wilkins, New York.

[72]Sihoe, A.D., Yim, A.P., Lee, T.W., Wan, S., Yuen, E.H., Wan, I.Y., Arifi, A.A., 2000. Can CT scanning be used to select patients with unilateral primary spontaneous pneumothorax for bilateral surgery? Chest, 118(2):380-383.

[73]Tomasdottir, G.F., Torfason, B., Isaksson, H.J., Gudbjartsson, T., 2007. Comparison of video-assisted thoracoscopic surgery, limited axillary thoracotomy for spontaneous pneumothorax. Laeknabladid, 93(5):405-412.

[74]Tschopp, J.M., Boutin, C., Astoul, P., Janssen, J.P., Grandin, S., Bolliger, C.T., Delaunois, L., Driesen, P., Tassi, G., Perruchoud, A.P., 2002. Talcage by medical thoracoscopy for primary spontaneous pneumothorax is more cost-effective than drainage: a randomised study. Eur. Respir. J., 20(4):1003-1009.

[75]Tschopp, J.M., Schnyder, J.M., Froudarakis, M., Astoul, P., 2009. VATS or simple talc poudrage under medical thoracoscopy for recurrent spontaneous pneumothorax. Eur. Respir. J., 33(2):442-443.

[76]Tsukioka, K., Okimoto, T., Koizumi, H., Mizukami, K., Muramatsu, H., Fukuda, S., Unno, K., Hirata, S., Yamashita, A., 1989. Angiographic findings in a patient with spontaneous hemopneumothorax. Kyobu Geka, 42(6):478-481.

[77]van Schil, P., de Vos, B., 2004. Current treatment of primary, secondary pneumothorax. Rev. Mal. Respir., 21(2 Pt. 1):372-380.

[78]van Schil, P.E., Hendriks, J.M., de Maeseneer, M.G., Lauwers, P.R., 2005. Current management of spontaneous pneumothorax. Monaldi. Arch. Chest Dis., 63(4):204-212.

[79]Vohra, H.A., Adamson, L., Weeden, D.F., 2008. Does video-assisted thoracoscopic pleurectomy result in better outcomes than open pleurectomy for primary spontaneous pneumothorax? Interact. Cardiovasc. Thorac. Surg., 7(4):673-677.

[80]Wakai, A., O′Sullivan, R.G., McCabe, G., 2007. Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults. Cochrane Database Syst. Rev., (1):CD004479.

[81]Wallach, S.L., 2000. Spontaneous pneumothorax. N. Engl. J. Med., 343(4):300-301.

[82]Wu, Y.C., Lu, M.S., Yeh, C.H., Liu, Y.H., Hsieh, M.J., Lu, H.I., Liu, H.P., 2002. Justifying video-assisted thoracic surgery for spontaneous hemopneumothorax. Chest, 122(5):1844-1847.

[83]Zehtabchi, S., Rios, C.L., 2008. Management of emergency department patients with primary spontaneous pneumothorax: needle aspiration or tube thoracostomy? Ann. Emerg. Med., 51(1):91-100.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Tong@ZJU

2010-10-19 09:00:45

Very helpful!

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE