scholarly journals Randomized controlled trial on the comparison of chest tube drainage and needle aspiration in the treatment of primary spontaneous pneumothorax

2018 ◽  
Vol 34 (6) ◽  
Author(s):  
Ali Ramouz ◽  
Mohammad Hossein Lashkari ◽  
Sanam Fakour ◽  
Seyed Ziaeddin Rasihashemi
Keyword(s):  
Randomized Controlled Trial ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Controlled Trial ◽  
Needle Aspiration ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Tube Drainage ◽  
Tube Drainage ◽  
Randomized Controlled

scholarly journals Digital versus analogue chest drainage system in patients with primary spontaneous pneumothorax: a randomized controlled trial

2020 ◽  
Author(s):  
Kris Mooren ◽  
Dieuwertje Ruigrok ◽  
Peter W.A. Kunst ◽  
Marielle M.J. Blacha ◽  
Ben Tomlow ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hospital Stay ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Controlled Trial ◽  
Drainage System ◽  
Air Leakage ◽  
Chest Drainage ◽  
Tube Drainage ◽  
Randomized Controlled

Abstract Background: Patients with a primary spontaneous pneumothorax (PSP) who are treated with chest tube drainage are traditionally connected to an analogue chest drainage system, containing a water seal and using a visual method of monitoring air leakage. Electronic systems with continuous digital monitoring of air leakage provide better insight into actual air leakage and changes in leakage over time, which may lead to a shorter length of hospital stay.Methods: We performed a randomized controlled trial comparing the digital with analogue system, with the aim of demonstrating that use of a digital drainage system in PSP leads to a shorter hospital stay.Results: In 102 patients enrolled with PSP we found no differences in total duration of chest tube drainage and hospital stay between the groups. However, in a post-hoc analysis, excluding 19 patients needing surgery due to prolonged air leakage, hospital stay was significantly shorter in the digital group (median 1 days, IQR 1-5 days) compared to the analogue group (median 3 days, IQR 2-5 days) (p 0.014). Treatment failure occurred in 3 patients in both groups; the rate of recurrence within 12 weeks was not significantly different between groups (16% in the digital group versus 8% in the analogue group, p 0.339).Conclusion: Length of hospital stay was not shorter in patients with PSP when applying a digital drainage system compared to an analogue drainage system. However, in the large subgroup of uncomplicated PSP, a significant reduction in duration of drainage and hospital stay was demonstrated with digital drainage. These findings suggest that digital drainage may be a practical alternative to manual aspiration in the management of PSP. Trial registration: https://www.trialregister.nl/trial/4022. Registered 22 September 2013 - Retrospectively registered, Trial NL4022 (NTR4195)

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.

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

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.

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