scholarly journals ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

2015 ◽  
Vol 46 (2) ◽  
pp. 321-335 ◽  
Author(s):  
Jean-Marie Tschopp ◽  
Oliver Bintcliffe ◽  
Philippe Astoul ◽  
Emilio Canalis ◽  
Peter Driesen ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Treatment Approach ◽  
Task Force ◽  
Scientific Evidence ◽  
Primary Spontaneous Pneumothorax ◽  
Definitive Treatment ◽  
Prospective Data ◽  
Randomised Controlled ◽  
Talc Poudrage

Primary spontaneous pneumothorax (PSP) affects young healthy people with a significant recurrence rate. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research.The European Respiratory Society's Scientific Committee established a multidisciplinary team of pulmonologists and surgeons to produce a comprehensive review of available scientific evidence.Smoking remains the main risk factor of PSP. Routine smoking cessation is advised. More prospective data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP, treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is available. Video-assisted thoracic surgery is preferred to thoracotomy as a surgical approach.In first episodes of PSP, aspiration is required only in symptomatic patients. After a persistent or recurrent PSP, definitive treatment including pleurodesis is undertaken. Future randomised controlled trials comparing different strategies are required.

scholarly journals Ambulatory management of primary spontaneous pneumothorax: an open-label, randomised controlled trial

The Lancet ◽  
2020 ◽  
Vol 396 (10243) ◽  
pp. 39-49 ◽  
Author(s):  
Rob J Hallifax ◽  
Edward McKeown ◽  
Parthipan Sivakumar ◽  
Ian Fairbairn ◽  
Christy Peter ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Spontaneous Pneumothorax ◽  
Controlled Trial ◽  
Primary Spontaneous Pneumothorax ◽  
Open Label ◽  
Randomised Controlled

scholarly journals Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: A single-institution experience in 861 cases

2006 ◽  
Vol 131 (2) ◽  
pp. 322-328 ◽  
Author(s):  
Giuseppe Cardillo ◽  
Francesco Carleo ◽  
Roberto Giunti ◽  
Luigi Carbone ◽  
Salvatore Mariotta ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
Single Institution ◽  
Talc Poudrage

scholarly journals Induction of Heme Oxygenase-1, Biliverdin Reductase and H-Ferritin in Lung Macrophage in Smokers with Primary Spontaneous Pneumothorax: Role of HIF-1α

PLoS ONE ◽  
2010 ◽  
Vol 5 (5) ◽  
pp. e10886 ◽  
Author(s):  
Delphine Goven ◽  
Anne Boutten ◽  
Véronique Leçon-Malas ◽  
Joëlle Marchal-Sommé ◽  
Paul Soler ◽  
...  
Keyword(s):  
Heme Oxygenase ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
Heme Oxygenase 1 ◽  
Biliverdin Reductase ◽  
Lung Macrophage

Video assisted thoracoscopic management of primary spontaneous pneumothorax

2020 ◽  
pp. 1-14
Author(s):  
Farhan Ahmed Majeed ◽  
Yasser Saeed Khan ◽  
Ahmed Raza ◽  
Tashfeen Imtiaz ◽  
Usama Zafar ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Case Series ◽  
Primary Spontaneous Pneumothorax ◽  
Definitive Treatment ◽  
Parietal Pleura ◽  
Air Leak ◽  
Video Assisted ◽  
Stage 4 ◽  
Prolonged Air Leak ◽  
Partial Pleurectomy

Abstract Objective: To analyze the outcome of Video assisted Thoracoscopy (Vats) in Primary Spontaneous Pneumothorax (PSP). Methods: This case series was carried out from Jan 2010 to Jan 2017 in Dept of Thoracic Surgery CMH Rawalpindi and Lahore. A total of 98 patients underwent Video-assisted thoracoscopic for PSP.  Inclusion criteria were physiologically fit patients with PSP for recurrent attacks, occupational hazards and prolonged air leak. Exclusion criteria included secondary spontaneous pneumothorax, previous pleurodesis and physiologically unfit patient for general anesthesia. Vanderschueren's thoracoscopic classification was used for macroscopic staging. A 3-port technique was used for apical stapling with partial pleurectomy up to 6th rib. Parietal pleura and diaphragm was also abraded. Results: Occupational hazard was the commonest indication for surgery, n= 39 (39.7%). This was followed by recurrent pneumothorax n=37 (37.7%), persistent air leak n= 19 (19.38%), and contra lateral pneumothorax n=4 (4.08). Mean age was 22.8 years ± 6.5. Majority of the cases were in stage 3 of Vanderschueren’s  classification, n=69 (70.4%). Stage 4 were n= 18 and stage 2 were n=7. Mean operative time was 51minutes ±14.4. Postoperative prolonged air leak occurred in 3 patients and post-operative neuralgia occurred in 8 patients. Mean follow-up was 22 months ± 5.5, range 5-24 months for all patients. One had generalized recurrence and 2 patients have subpulmonic trapping of air. Conclusions: Video-assisted thoracoscopic stapling and pleurectomy is an effective definitive treatment for primary spontaneous pneumothorax when indicated with minimal recurrence. Keywords: Video-assisted thoracoscopy, blebs, pneumothorax. Continuous...

scholarly journals The role of telomerase in the etiology of primary spontaneous pneumothorax

2021 ◽  
Vol 29 (3) ◽  
pp. 377-383
Author(s):  
Mehmet Akif Tezcan ◽  
İbrahim Ethem Özsoy ◽  
Fatih Gürler ◽  
Çiğdem Karakükçü
Keyword(s):  
Spontaneous Pneumothorax ◽  
Telomerase Activity ◽  
Primary Spontaneous Pneumothorax ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Healthy Individuals ◽  
Genetic Studies ◽  
Thoracic Computed Tomography ◽  
The Mean

Background: This study aims to investigate the role of telomerase activity in the risk of primary spontaneous pneumothorax, which is most frequently encountered in the practice of thoracic surgery. Methods: A total of 61 patients (56 males, 5 females; median age: 29.4 years; range, 17 to 43 years) who underwent treatment for primary spontaneous pneumothorax and 19 age- and sex-matched healthy controls (10 males, 9 females; median age: 29.1 years; range, 23 to 43 years) were included in this prospective study between January 2018 - August 2018. Telomerase activity was evaluated with enzyme-linked immunosorbent assay. The correlation between telomerase activity and clinical and demographic parameters was examined. Results: The mean serum telomerase level was 3.4±0.6 ng/mL in the primary spontaneous pneumothorax group and 1.9±0.5 ng/mL in the control group, indicating significantly higher levels in the patient group (p<0.001). There was no significant association between the telomerase levels and presence of blebs and/or bullae on thoracic computed tomography, extent of pneumothorax, laterality (right, left, or bilateral), and pack years of cigarette smoking. Conclusion: Telomerase levels of patients with primary spontaneous pneumothorax are significantly higher than healthy individuals. Future genetic studies may ultimately clarify a potential relationship between primary spontaneous pneumothorax and short telomere syndrome.

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