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Eur J Pediatr Surg 2022; 32(05): 415-421
DOI: 10.1055/s-0041-1739420
Original Article

European Pediatric Surgeons' Association Survey on the Management of Primary Spontaneous Pneumothorax in Children

Tutku Soyer 
1   Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
,
Anne Dariel
2   Department of Pediatric Surgery, AP-HM, Marseille, Provence-Alpes-Côte d'Azur, France
,
Jens Dingemann 
3   Centre of Pediatric Surgery, Hannover Medical School and “Auf der Bult” Children's Hospital Hannover, Hannover, Germany
,
Leopoldo Martinez
4   Department of Pediatric Surgery, Hospital La Paz, Madrid, Spain
,
Alessio Pini-Prato
5   Department of Pediatric Surgery, Umberto Bosio Center for Digestive Diseases The Children Hospital AO SS Antonio e Biagio e Cesare Arrigo Alessandria, Italy, EU
,
Francesco Morini
6   Department of Medical and Surgical Neonatology, Azienda Ospedaliero Universitaria Meyer, Firenze, Toscana, Italy
,
Paolo De Coppi
7   Department of Paediatric Surgery, Great Ormond Street Hospital for Children, London, United Kingdom
,
Ramon Gorter
8   Department of Pediatric Surgery, Amsterdam UMC, University of Amsterdam & Vrije Universiteit, Amsterdam, Noord-Holland, the Netherlands
,
Takashi Doi
9   Division of Pediatric Surgery, Department of Surgery, Kansai Medical University, Osaka, Japan
,
Sanja Sindjic Antunovic
10   Department of Pediatric Surgery, University Children's Hospital, Belgrade, Serbia
,
Mohit Kakar
11   Department of Pediatric Surgery, Riga Stradins University & Children's Clinical University Hospital, Riga, Latvia
,
Nigel J. Hall
12   University Surgery Unit, Faculty of Medicine, University of Southampton, United Kingdom
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Abstract

Aim To evaluate the practice patterns of the European Pediatric Surgeons' Association (EUPSA) members regarding the management of primary spontaneous pneumothorax (PSP) in children.

Methods An online survey was distributed to all members of EUPSA.

Results In total, 131 members from 44 countries participated in the survey. Interventional approach (78%) is the most common choice of treatment in the first episode, and most commonly, chest tube insertion (71%) is performed. In the case of a respiratory stable patient, 60% of the responders insert chest tubes if the pneumothorax is more than 2 cm. While 49% of surgeons prefer surgical intervention in the second episode, 42% still prefer chest tube insertion. Main indications for surgical treatment were the presence of bullae more than 2 cm (77%), and recurrent pneumothorax (76%). Eighty-four percent of surgeons prefer thoracoscopy and perform excision of bullae with safe margins (91%). To prevent recurrences, 54% of surgeons perform surgical pleurodesis with pleural abrasion (55%) and partial pleurectomy (22%). The responders who perform thoracoscopy use more surgical pleurodesis and prefer shorter chest tube duration than the surgeons performing open surgery (p < 0.05).

Conclusion Most of the responders prefer chest tube insertion in the management of first episode of PSP and perform surgical treatment in the second episode in case of underlying bullae more than 2 cm and recurrent pneumothorax. The surgeons performing thoracoscopy use more surgical pleurodesis and prefer shorter chest tube duration than the responders performing open surgery. The development of evidence-based guidelines may help standardize care and improve outcomes in children with PSP.

Keywords

primary spontaneous pneumothorax - children - pleurodesis - survey


Publication History

Received: 02 July 2021

Accepted: 01 October 2021

Article published online:
25 November 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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