Zentralbl Chir 2018; 143(S 01): S12-S43
DOI: 10.1055/a-0588-4444
Guideline/Leitlinie
Georg Thieme Verlag KG Stuttgart · New York

Management of Spontaneous Pneumothorax and Postinterventional Pneumothorax: German S3-Guideline[*]

Article in several languages: English | deutsch
Jost Schnell
1   Lungenklinik Köln-Merheim, Lehrstuhl Thoraxchirurgie der Universität Witten-Herdecke
,
Meinrad Beer
2   Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm
,
Stephan Eggeling
3   Klinik für Thoraxchirurgie, Vivantes Klinikum Neukölln, Berlin
,
Wolfgang Gesierich
4   Klinik für Pneumologie, Asklepios-Fachkliniken München Gauting
,
Jens Gottlieb
5   Klinik für Pneumologie, Medizinische Hochschule Hannover
,
Felix Herth
6   Abteilung für Pneumologie und Beatmungsmedizin, Thoraxklinik Universitätsklinikum Heidelberg
,
Hans-Stefan Hofmann
7   Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg
,
Berthold Jany
8   Medizinische Klinik - Schwerpunkt Pneumologie und Beatmungsmedizin, KWM Missioklinik Würzburg
,
Michael Kreuter
6   Abteilung für Pneumologie und Beatmungsmedizin, Thoraxklinik Universitätsklinikum Heidelberg
,
Julia Ley-Zaporozhan
9   Klinik und Poliklinik für Radiologie, Klinikum der Ludwig-Maximilans-Universität München
,
Robert Scheubel
10   Klinik für Thoraxchirurgie, Fachkliniken Wangen
,
Thorsten Walles
11   Abteilung Thoraxchirurgie, Universitätsklinik für Herz- und Thoraxchirurgie Magdeburg
,
Sebastian Wiesemann
12   Klinik für Thoraxchirurgie, Universitätsklinikum Freiburg
,
Heinrich Worth
13   Klinik für Herz- und Lungenerkrankungen, Klinikum Fürth
,
Erich Stoelben
1   Lungenklinik Köln-Merheim, Lehrstuhl Thoraxchirurgie der Universität Witten-Herdecke
› Author Affiliations
Further Information

Publication History

Publication Date:
24 July 2018 (online)

Abstract

In Germany, 10,000 cases of spontaneous pneumothorax are treated inpatient every year. The German Society for Thoracic Surgery (DGT), in co-operation with the German Society for Pulmonology (DGP), the German Radiological Society (DRG) and the German Society of Internal Medicine (DGIM) has developed an S3 guideline on spontaneous pneumothorax and postinterventional pneumothorax moderated by the German Association of Scientific Medical Societies (AWMF).

Method Based on the source guideline of the British Thoracic Society (BTS2010) for spontaneous pneumothorax, a literature search on spontaneous pneumothorax was carried out from 2008 onwards, for post-interventional pneumothorax from 1960 onwards. Evidence levels according to the Oxford Center for Evidence-Based Medicine (2011) were assigned to the relevant studies found. Recommendations according to GRADE (A: “we recommend”/“we do not recommend”, B: “we suggest”/“we do not suggest”) were determined in three consensus conferences by the nominal group process.

Results The algorithms for primary and secondary pneumothorax differ in the indication for CT scan as well as in the indication for chest drainage application and video-assisted thoracic surgery (VATS). Indication for surgery is recommended individually taking into account the risk of recurrence, life circumstances, patient preferences and procedure risks. For some forms of secondary pneumothorax, a reserved indication for surgery is recommended. Therapy of postinterventional spontaneous pneumothorax is similar to that of primary spontaneous pneumothorax.

Discussion The recommendations of the S3 Guideline provide assistance in managing spontaneous pneumothorax and post-interventional pneumothorax. Whether this will affect existing deviant diagnostic and therapeutic measures will be demonstrated by future epidemiological studies.

* This guideline has been simultaneously published in German language in Zentralblatt für Chirurgie (doi:10.1055/a-0588-4444) and in Respiration (doi:10.1159/000490179).


 
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