Background: Surgery as the primary management strategy for pediatric primary spontaneous pneumothorax is controversial. This study aims to evaluate the outcomes and effectiveness of management approaches for pediatric spontaneous pneumothorax.
Methods: Outcomes of pediatric patients undergoing initial nonoperative treatment versus video-assisted thoracoscopic surgery with blebectomy and mechanical pleurodesis were compared via a retrospective review.
Results: We identified 96 patients with 108 pneumothoraces. Of 98 pneumothoraces with initial nonoperative management, 37% had surgery during their initial hospitalization for persistent air leak. Of those discharged home without video-assisted thoracoscopic surgery, 40% recurred. Initial nonoperative management resulted in more total hospital days (median: 11 vs 5 days, P < .001). No significant predictors of recurrence were identified on multivariate analysis. Sixty-three percent of all patients ultimately required surgery.
Conclusions: Fewer than 40% of primary spontaneous pneumothorax patients are definitively treated with nonoperative management. A prospective study is needed to determine whether primary surgery with blebectomy/mechanical pleurodesis is a more effective treatment strategy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.amjsurg.2014.06.009 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Continuous serratus anterior block for sternotomy analgesia after cardiac surgery: a single-centre feasibility study.
Br J Anaesth
January 2025
Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.
Background: Moderate-to-severe pain is common after cardiac surgery, peaking during the first and second postoperative days. Several nerve blocks for sternotomy have been described; however, the optimal location for continuous catheters has not been established. This study assessed the feasibility of a larger trial evaluating the efficacy of serratus anterior plane (SAP) catheter analgesia for sternotomy pain.
View Article and Find Full Text PDFDiaphragmatic stripping versus full-thickness diaphragmatic resection in cytoreductive surgery: a meta-analysis of the current evidence.
Langenbecks Arch Surg
January 2025
Department of Surgery (A), Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University, Moorenstr. 5, 40225, Duesseldorf, Germany.
Purpose: The primary objective was to compare the intra- and postoperative outcomes of diaphragmatic stripping versus full-thickness diaphragmatic resection in patients with peritoneal carcinomatosis who underwent cytoreductive surgery.
Methods: According to the PRSIMA guidelines, a comprehensive literature search was conducted for studies comparing postoperative pulmonary complications as well as intra- and postoperative outcomes of diaphragmatic stripping versus full-thickness diaphragmatic resection in patients with peritoneal carcinomatosis necessitating cytoreductive surgery. Data from eligible studies were extracted, qualitatively assessed, and included in a meta-analysis.
Lymphangioleiomyomatosis and Pregnancy-Do We Have All the Answers for a Woman Who Desires to Conceive?-Literature Review.
Cancers (Basel)
January 2025
Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Lymphangioleiomyomatosis (LAM) is a rare, progressive, and poor-prognosis systemic disorder that primarily affects women of reproductive age, with a higher prevalence among individuals of Caucasian origin. However, there are limited reliable data on the prevalence of LAM during pregnancy. The fulminant respiratory clinical presentation that often includes progressive dyspnea on exertion, cough, or hemoptysis, frequently complicated by pneumothorax, and the increased risk of spontaneous abortion due to increased estrogen and progesterone production during gestation, are arguments that most often make the diagnosed woman avoid pregnancy.
View Article and Find Full Text PDFEarly Effects of Bronchoscopic Cryotherapy in Metastatic Non-Small Cell Lung Cancer Patients Receiving Immunotherapy: A Single-Center Prospective Study.
Diagnostics (Basel)
January 2025
Department of Pulmonology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
Cryotherapy is used for local tissue destruction through rapid freeze-thaw cycles. It induces cancer cell necrosis followed by inflammation in the treated tumor microenvironment, and it stimulates systemic adaptive immunity. Combining cryotherapy with immunotherapy may provide a sustained immune response by preventing T cell exhaustion.
View Article and Find Full Text PDFPost-discharge complications and follow-up timing after hospitalization for traumatic rib fractures.
Eur J Trauma Emerg Surg
January 2025
Division of General Surgery, Department of Surgery, Stanford University, Stanford, USA.
Purpose: To evaluate frequency and timing of post-discharge complications in patients with traumatic rib fractures undergoing operative or nonoperative management.
Methods: We retrospectively reviewed adult patients with rib fractures admitted to a Level 1 trauma center from 1/2020 to 12/2021. Outcomes included rib-related complications, pneumonia within 1 month, new diagnosis of opioid- or alcohol-use disorder, and all-cause mortality.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!