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J Korean Soc Emerg Med > Volume 14(4); 2003 > Article
Journal of The Korean Society of Emergency Medicine 2003;14(4): 403-408.
Comparison of Simple Manual Aspiration and Chest Tube Drainage in the First Occurrence of a Primary Spontaneous Pneumothorax
Sang Woo Oh, Sung Youl Hyun, Hyuk Jun Yang, Yong Su Lim, Jae Kwang Kim, Gun Lee
1Department of Emergency Medicine, Gil Medical Center, Gachon Medical School, Incheon, Korea. yongem@netian.com
2Department of Thoracic & Cardiovascular Surgery, Gil Medical Center, Gachon Medical School, Incheon, Korea.
The aim of this prospective study was to determine the safety and the efficacy of simple manual aspiration, as an initial treatment for the first occurrence of a primary spontaneous pneumothorax, as opposed to chest tube drainage.
From January 2002 to December 2002, 98 patients were admitted for the first occurrence of a primary spontaneous pneumothorax. They were divided into 3 groups according to sizes of the pneumothoraces and the treatment modalities: (1) size<25% (n=21; rest and oxygen therapy), (2) 2580% (n=20; chest tube drainage). Fifty-seven patients with pneumothorax size of 25 to 80% were randomly treated with simple manual aspiration (SMA; n=30) or with chest tube drainage (CTD; n=27).
The therapy was successful in 24 out of 30 patients (80.0%) in the SMA group and in 22 out of 27 patients (81.5%) in the CTD group (p=0.89). The recurrence rates at 3 months for the two groups were similar (6.7% and 11.1%, respectively; p =0.55). The hospital stay was significantly shorter in the SMA group than in the CTD group (4.2+/-3.27 and 7.5+/-2.77 days, respectively; p<0.01). Most of the treatment failures in the SMA group involved pneumothorax sizes greater than 50% (5 out of 6).
This study indicates that simple manual aspiration seems to be as effective and safe as chest tube drainage. Especially, simple manual aspiration may be proposed as a first-line treatment in the first occurrence of a primary spontaneous pneumothorax with a size smaller than 50%.
Key words: Pneumothorax, Treatment, Aspiration
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