Thorac cardiovasc Surg 2014; 62(06): 516-520
DOI: 10.1055/s-0034-1374650
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Outcomes of Outpatient Treatment for Primary Spontaneous Pneumothorax Using a Small-Bore Portable Thoracic Drainage Device

Takahiro Karasaki
1  Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan
3  Department of Surgery, Asahi General Hospital, Asahi, Japan
,
Shizuya Shintomi
2  Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan
,
Yukihiro Nomura
3  Department of Surgery, Asahi General Hospital, Asahi, Japan
,
Nobutaka Tanaka
3  Department of Surgery, Asahi General Hospital, Asahi, Japan
,
Haruhisa Saito
4  Department of Respiratory Medicine, Asahi General Hospital, Asahi, Japan
,
Yukihiro Yoshida
3  Department of Surgery, Asahi General Hospital, Asahi, Japan
› Author Affiliations
Further Information

Publication History

07 January 2014

27 February 2014

Publication Date:
29 May 2014 (eFirst)

Abstract

Background There is no consensus regarding the initial intervention for primary spontaneous pneumothorax. We report the outcomes of outpatient treatment for primary spontaneous pneumothorax using a portable thoracic drainage device.

Patients and Methods Between April 2007 and December 2011, 99 consecutive patients with a first episode of primary spontaneous pneumothorax were indicated for insertion of a portable thoracic drainage device. All patients were treated with a small-bore portable thoracic drainage device that consists of a flexible 9F silicone catheter with one-way valves and a small plastic chamber. Successful treatment was defined as when the pneumothorax was resolved after the insertion of a portable thoracic drainage device solely on an outpatient basis. Demographic data and treatment outcomes were obtained by a retrospective chart review.

Results Ninety-seven patients (98%) with a first primary spontaneous pneumothorax were discharged from the emergency department after insertion of a portable thoracic drainage device. Ninety-three patients (94%) resolved with outpatient treatment. The median duration of portable thoracic drainage device insertion was 4 days (range, 0–33 days). The recurrence rate after treatment with a portable thoracic drainage device was 34% (32/93). There were two infections (2.0%), two instances of hemothoraces (2.0%), and one severe discomfort at the insertion site (1.0%). There were no cases of tension pneumothorax or reexpansion edema.

Conclusion Outpatient treatment for primary spontaneous pneumothorax using a portable thoracic drainage device had a high success rate with few serious complications and an acceptable recurrence rate.