scholarly journals Randomised comparison of needle aspiration and chest tube drainage in spontaneous pneumothorax

2017 ◽  
Vol 49 (4) ◽  
pp. 1601296 ◽  
Author(s):  
A. Thelle ◽  
M. Gjerdevik ◽  
M. SueChu ◽  
O. M. Hagen ◽  
P. Bakke
Keyword(s):  
Hospital Stay ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Needle Aspiration ◽  
Chest Tube Drainage ◽  
Success Rates ◽  
Adherence To Guidelines ◽  
Tube Drainage ◽  
Significant Difference ◽  
Positive Effect

Guidelines on spontaneous pneumothorax are contradictory as to intervention between needle aspiration (NA) and chest tube drainage (CTD). Studies show poor adherence to guidelines.Three Norwegian hospitals included patients with primary (PSP) and secondary (SSP) spontaneous pneumothorax. Patients underwent NA or CTD as the primary intervention. The main outcome was duration of hospital stay. Secondary outcomes were immediate- and 1-week success rates and complications.127 patients were included, including 48 patients with SSP. 65 patients underwent NA, 63 patients CTD. Median (interquartile range) hospital stay was significantly shorter for NA: 2.4 days (1.2–4.7 days), compared with CTD: 4.6 days (2.3–7.8 days) (p<0.001). The corresponding figures for the SSP subgroup were 2.54 days (1.17–7.79 days) compared with 5.53 days (3.65–9.21 days) (p=0.049) for NA and CTD, respectively. Immediate success rates were 69% for NA compared with 32% for CTD (p<0.001). The positive effect of NA remained significant in sub-analyses for SSP. There was no significant difference in 1-week success rates. Complications occurred only during the CTD-treatment.Our study shows shorter hospital stay and higher immediate success rates for NA compared with CTD. Subgroup analyses also show clear benefits for NA for both PSP and SSP.

Randomized comparison of needle aspiration and chest tube drainage in spontaneous pneumothorax

2016 ◽  
Author(s):  
Andreas Thelle ◽  
Miriam Gjerdevik ◽  
Malcolm SueChu ◽  
Ole Magnus Hagen ◽  
Per Bakke
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Needle Aspiration ◽  
Chest Tube Drainage ◽  
Tube Drainage

Postoperative complications following the Fontan procedure: the role of aprotinin

Perfusion ◽  
2011 ◽  
Vol 26 (6) ◽  
pp. 529-535 ◽  
Author(s):  
D Klugman ◽  
MT Donofrio ◽  
D Zurakowski ◽  
RA Jonas
Keyword(s):  
Postoperative Complications ◽  
Chest Tube ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Multivariate Logistic Regression Analysis ◽  
Chest Tube Drainage ◽  
Control Group ◽  
Tube Drainage ◽  
Significant Difference ◽  
Anti Inflammatory

Objective: To determine how the anti-inflammatory properties of aprotinin impact on postoperative complications in children undergoing the Fontan procedure. Methods: We included all patients between 14 months and 18 years (n=56) undergoing a Fontan operation at our institution between January 2005 and June 2009. The study group (n=29) included patients from January 2005 through December 2007 all of whom received aprotinin. The control group (n=27) included all patients from January 2008 through June 2009 who did not receive aprotinin. We reviewed all medical records and collected preoperative, intraoperative and postoperative data. Duration and volume of chest tube drainage were the primary outcome measures. Results: Of the 20% of patients who had postoperative arrhythmias, multivariate logistic regression analysis demonstrated only aprotinin was associated with significantly decreased postoperative arrhythmias ( P=0.01). Renal function and fenestration or Fontan thrombosis did not differ significantly; there was no statistically significant difference in volume or duration of chest tube drainage. Median duration of chest tube drainage was 7 days in the aprotinin group and 8 days for patients who did not receive aprotinin ( P=0.36). Conclusion: The anti-inflammatory properties of aprotinin may be protective against postoperative arrhythmias. Aprotinin does not confer increased risks of prolonged chest tube drainage, renal dysfunction or thrombosis in patients undergoing the Fontan procedure.

scholarly journals Chest tube drainage versus video-assisted thoracoscopic surgery for a first episode of primary spontaneous pneumothorax: a systematic review and meta-analysis

2019 ◽  
Vol 56 (5) ◽  
pp. 819-829
Author(s):  
Jean H T Daemen ◽  
Pieter W J Lozekoot ◽  
Jos G Maessen ◽  
Michiel H M Gronenschild ◽  
Gerben P Bootsma ◽  
...  
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Meta Analysis ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Tube Drainage ◽  
Recurrence Rates ◽  
Tube Drainage ◽  
Ipsilateral Recurrence ◽  
Length Of Hospitalization

Summary Primary spontaneous pneumothorax affects up to 28 patients per 100 000 population yearly and is commonly resolved by chest tube drainage. However, drainage is also known to be associated with ipsilateral recurrence rates ranging from 25% to 43%. Preventive video-assisted thoracoscopic surgery (VATS) may be an effective alternative to diminish these recurrence rates and its associated morbidity. The aim of this study was to compare the efficacy of chest tube drainage and VATS as first line treatments of an initial episode of primary spontaneous pneumothorax. The MEDLINE, EMBASE, CENTRAL and Clinicaltrials.gov databases were searched through 16 September 2018. Data regarding the ipsilateral recurrence rate and the length of hospitalization were extracted and submitted to meta-analysis using the random-effects model and the I2 test for heterogeneity. Two randomized controlled trials and 2 observational studies were included, enrolling a total of 479 patients. Pairwise analysis demonstrated significantly reduced ipsilateral recurrence rates [odds ratio 0.15, 95% confidence interval (CI) 0.07–0.33; P < 0.00001] and length of hospitalization (standardized mean difference −2.19, 95% CI −4.34 to −0.04; P = 0.046) in favour of VATS. However, a significant level of heterogeneity was detected for the length of hospitalization (I2 = 97%; P < 0.00001). Subgroup analysis that stratified study design found no statistical differences regarding recurrence rate. In conclusion, VATS can be an effective and attractive alternative to standard chest tube drainage, with reduced ipsilateral recurrence rates and length of hospitalization. However, given the low quality of the majority of included studies, more well-designed randomized controlled trials are necessary to strengthen the current evidence.

scholarly journals Chest Tube Drainage Versus Conservative Management as the Initial Treatment of Primary Spontaneous Pneumothorax: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (11) ◽  
pp. 3456
Author(s):  
Jong Hyuk Lee ◽  
Ryul Kim ◽  
Chang Min Park
Keyword(s):  
Adverse Events ◽  
Conservative Management ◽  
Chest Tube ◽  
Initial Treatment ◽  
Spontaneous Pneumothorax ◽  
Meta Analysis ◽  
Chest Tube Drainage ◽  
Regression Analyses ◽  
Tube Drainage ◽  
Meta Regression

Objectives: This systematic review and meta-analysis aimed to compare chest tube drainage and conservative management as the initial treatment of primary spontaneous pneumothorax (PSP). Methods: Studies including PSP patients who received tube drainage or conservative management as the initial treatment were searched in OVID-MEDLINE and Embase through 14 February 2020. The primary outcome was the relative risk (RR) of PSP recurrence, and secondary outcomes were RRs of PSP resolution and adverse events during treatment. A random-effect model using the Mantel–Haenszel method was used to pool RRs. Subgroup and meta-regression analyses were performed to investigate significant predictors of PSP recurrence. Results: In total, 11,922 PSP cases from eight studies were analysed, of which 6344 were treated with tube drainage and 5578 were treated with conservative management. The pooled RR of PSP recurrence for conservative management against tube drainage was 0.98 (95% confidence interval [CI], 0.75–1.28; p = 0.894). Subgroup and meta-regression analyses revealed that study design (p = 0.816), allocation of the PSP amount in each management group (p = 0.191), and assessment time for recurrence had no significant impact on PSP recurrence (p = 0.816). There was no publication bias (p = 0.475). The risk of adverse events of conservative management was significantly lower than that of tube drainage (pooled RR, 0.22; 95% CI, 0.08–1.15; p = 0.003). However, no difference was found between the two groups in terms of PSP resolution (pooled RR, 1.01; 95% CI, 0.9–1.15; p = 0.814). Conclusions: As the initial treatment for PSP, conservative management is comparable to chest tube drainage in terms of PSP recurrence and resolution after treatment, with fewer adverse events during treatment.

Manual Aspiration versus Chest Tube Drainage in First Episodes of Primary Spontaneous Pneumothorax

2002 ◽  
Vol 165 (9) ◽  
pp. 1240-1244 ◽  
Author(s):  
Marc Noppen ◽  
Patrick Alexander ◽  
Peter Driesen ◽  
Hans Slabbynck ◽  
André Verstraeten
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Tube Drainage ◽  
Tube Drainage
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