Simple aspiration and drainage and intrapleural minocycline pleurodesis versus simple aspiration and drainage for the initial treatment of primary spontaneous pneumothorax: an open-label, parallel-group, prospective, randomised, controlled trial.

Background: Simple aspiration and drainage is a standard initial treatment for primary spontaneous pneumothorax, but the rate of pneumothorax recurrence is substantial. We investigated whether additional minocycline pleurodesis after simple aspiration and drainage reduces the rate of recurrence.

Methods: In our open-label, parallel-group, prospective, randomised, controlled trial at two hospitals in Taiwan, patients were aged 15-40 years and had a first episode of primary spontaneous pneumothorax with a rim of air greater than 2 cm on chest radiographs, complete lung expansion without air leakage after pigtail catheter drainage, adequate haematological function, and normal renal and hepatic function.

Salvage for unsuccessful aspiration of primary pneumothorax: thoracoscopic surgery or chest tube drainage?

Background: Simple aspiration is recommended as first-line treatment for all primary spontaneous pneumothoraces requiring intervention. However, the optimal salvage treatment remains unclear when simple aspiration is unsuccessful for controlling symptoms. In this study, the safety, efficacy, and estimated costs of video-assisted thoracoscopic surgery (VATS) and chest tube drainage (CTD) were compared.

Intrapleural minocycline following simple aspiration for initial treatment of primary spontaneous pneumothorax.

Background: The optimal initial management of primary spontaneous pneumothorax (PSP) remains controversial. This study was to evaluate the safety and efficacy of intrapleural minocycline following aspiration for initial treatment of PSP.

Methods: Between January 2004 and November 2006, 64 patients with a first episode of PSP were successfully treated by simple aspiration using pigtail or intravenous needle catheter.