Optimal treatment of pneumothorax in adolescents with Marfan syndrome
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Read the article on jpedsurg.org ↗Article · Mar 2021 · 1 min read
In brief
In brief
Retrospective study of 23 adolescent Marfan syndrome patients with pneumothorax demonstrates 78% recurrence rate and 57% conservative treatment failure requiring surgical intervention. Surgical treatment showed significantly lower ipsilateral relapse (13%) compared to conservative management (67%), supporting early surgical intervention as first-line therapy in this population.
Written by the GCMD Library team from the article.
Abstract
Purpose
: Pneumothorax often develops in patients with Marfan syndrome (MFS). Here, we examined the effects of conservative and surgical pneumothorax treatments in children with MFS.
Methods
: In this study, 23 patients, less than 20 years old, diagnosed with both MFS and pneumothorax between 1999 and 2019 were included. All data were collected retrospectively from patients' medical records.
Results
: In total, 18 of 23 patients (78%) had relapsed pneumothorax either on the ipsilateral or contralateral side. Among these 18 patients, 6 (26%) patients had multiple relapses. Conservative and surgical treatments of pneumothorax were attempted in 33 and 29 lungs, respectively. The conservative treatment was attempted as a definitive therapy in 21 lungs. Twelve conservative treatments (57%) failed, which required surgical intervention. In 9 lungs (43%) with successful conservative treatment, 6 (67%) had ipsilateral relapses. In contrast to the above findings, only 4 (13%) ipsilateral relapses were observed in 29 surgical treatments.
Conclusions
: Our study revealed a low response and high relapse rate when MFS adolescents who diagnosed pneumothorax were subjected to the conservative treatment modality. Thus, we recommend surgical intervention as the first line of therapy to treat pneumothorax in adolescents diagnosed with MFS.
Level of Evidence
: Ⅲ (Treatment Study)