# Primary Spontaneous Pneumothorax — GCMD Library living collection

Everything in the library about primary spontaneous pneumothorax — built automatically from dossiers that name it.

Updated: n/a · 4 episodes · 51 cited statements

## Episodes
### Acute Management
- [Spontaneous Pneumothorax](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521) — podcast · 33:31 · [machine version](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521.md)

### Evidence & Research
- [Management of Primary Spontaneous Pneumothorax in Children](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190) — video · [machine version](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190.md)
- [Journal of Pediatric Surgery Article REview: August Issue 2023](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977) — podcast · 17:30 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977.md)

### Case-Based Learning
- [Spontaneous Pneumothorax: Lung Lesions](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086) — video · 22:21 · [machine version](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=0) Case presentation and initial management polling (Ep 1)
- [4:36](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=276) Anesthesia approach and rationale for early VATS (Ep 1)
- [10:08](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=608) Role and timing of CT imaging (Ep 1)
- [15:17](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=917) Surgical approach for unilateral and bilateral disease (Ep 1)
- [19:03](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1143) Pleurodesis techniques and recurrence prevention (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=0) Introduction and Case Presentation (Ep 2)
- [3:05](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=185) Retrospective Data on Chest Tube Outcomes (Ep 2)
- [8:59](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=539) Aspiration Protocol and Study Design (Ep 2)
- [14:22](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=862) Aspiration Study Results (Ep 2)
- [19:38](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1178) Clinical Application and Family Counseling (Ep 2)
- [23:27](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1407) Pleurodesis Evidence (Ep 2)
- [26:05](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1565) Role of CT Imaging (Ep 2)
- [27:31](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1651) Management of Recurrent Cases (Ep 2)
- [31:38](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1898) Future Directions and Closing (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0) Retrospective Analysis of Spontaneous Pneumothorax Management in Adolescents (Ep 3)
- [0:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=0) Cryoablation in Nuss Procedures: Impact on Hospital Stay and Opioid Use (Ep 4)
- [5:07](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=307) Management of Primary Spontaneous Pneumothorax in Children (Ep 4)
- [8:23](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=503) Updated APSA Guidelines for Solid Organ Injury Management (Ep 4)
- [11:16](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=676) Cryoablation for Slipping Rib Syndrome (Ep 4)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "There is disagreement in the literature on management of primary spontaneous pneumothorax, with no clear evidence supporting any particular approach." — Mark (opinion) [Ep 1 · 0:09](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=9)
- "The majority of children at their institution elect to undergo general anesthesia rather than bedside chest tube placement under local anesthesia." — Mark (clinical) [Ep 1 · 6:23](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=383)
- "50% of patients who undergo chest tube placement or observation for pneumothorax will have recurrence and need additional intervention." — Mark (epidemiological) [Ep 1 · 6:43](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=403)
- "Among patients with bleb disease who undergo simple chest tube placement for symptomatic pneumothorax, upwards of 50% will recur." — Mark (epidemiological) [Ep 1 · 7:27](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=447)
- "Second recurrence rate is approximately 75%." — Mark (epidemiological) [Ep 1 · 8:03](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=483)
- "No study has separated patients on first event into those with blebs versus no blebs and examined risk of second event recurrence." — Mark (clinical) [Ep 1 · 8:23](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=503)
- "A CT scan is not very effective for visualizing blebs when the lung is partially collapsed." — Mark (clinical) [Ep 1 · 8:45](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=525)
- "Almost all patients with spontaneous pneumothorax have bleb disease whether it is defined early or not." — Mark (opinion) [Ep 1 · 13:14](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=794)
- "Bleb disease does not necessarily mean recurrence will occur." — Mark (opinion) [Ep 1 · 13:28](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=808)
- "Patients with spontaneous pneumothorax usually recur when at home, not in remote locations or extremis." — Mark (clinical) [Ep 1 · 14:41](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=881)
- "A recent study from Saint Peter in Kansas City found CT scan was very poor at defining bleb disease compared to subsequent thoracoscopy." — Mark (host_summary) [Ep 1 · 13:00](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=780)
- "More people are using chemical pleurodesis instead of mechanical pleurodesis and finding better results, shorter OR times, and decreased recurrence rates." — Mark (host_summary) [Ep 1 · 19:08](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1148)
- "There is still a pretty high recurrence rate even after VATS with blebectomy and mechanical or chemical pleurodesis." — Mark (clinical) [Ep 1 · 19:08](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1148)
- "In Argentina, for stable patients with pneumothorax, they place a thin double pigtail catheter percutaneously with local anesthesia, attached to a Heimlich valve." — Marcello (clinical) [Ep 1 · 9:04](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=544)
- "Most patients with spontaneous pneumothorax are adolescents (around 18 years old)." — Marcello (clinical) [Ep 1 · 5:12](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=312)
- "Aerosolized talc can be administered through a chest tube, creating a 'snow' effect inside the chest for pleurodesis." — Todd (clinical) [Ep 1 · 20:03](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1203)
- "Apical pleurectomy causes more postoperative pain than talc pleurodesis." — Todd (opinion) [Ep 1 · 19:57](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1197)
- "Talc pleurodesis creates random massive chemical pleurodesis throughout the chest, which may complicate future thoracic surgery." — Todd (host_summary) [Ep 1 · 20:23](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1223)
- "Apical pleurectomy is limited to the apex of the lung, typically down to the third intercostal space when apical blebs are present." — Todd (host_summary) [Ep 1 · 20:33](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1233)
- "When no blebs are visible on thoracoscopy, the apex can be sealed with a ligature and apical pleurectomy performed." — Todd (host_summary) [Ep 1 · 22:00](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1320)
- "Hydrostatic pleurectomy technique involves making a small pleural incision, inserting a suction irrigator, sealing around it, and irrigating to dissect the entire pleura, which can then be rolled up and removed." — Mark (clinical) [Ep 1 · 20:48](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1248)
- "Hydrostatic pleurectomy can achieve hemi-thorax pleural removal, more extensive than apical pleurectomy alone." — Mark (clinical) [Ep 1 · 21:11](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1271)
- "After unilateral treatment of symptomatic pneumothorax, recurrence can occur on the contralateral side during the immediate postoperative period." — Giovanna (clinical) [Ep 1 · 17:51](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-lung-lesions-1086?t=1071)
- "Primary spontaneous pneumothorax is more common in males by approximately 3 to 1 ratio" — Dan Osley (epidemiological) [Ep 2 · 1:42](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=102)
- "CT scan data fairly convincingly shows that it is probably not beneficial with regard to changing treatment parameters or outcomes for spontaneous pneumothorax" — Dan Osley (clinical) [Ep 2 · 3:05](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=185)
- "In multi-institutional retrospective trial, chest tubes worked about 50% of the time for spontaneous pneumothorax" — Dan Osley (clinical) [Ep 2 · 3:32](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=212)
- "The failure rate for patients who get a chest tube and resolve is about 50% - they will be back and have to have another operation" — Dan Osley (clinical) [Ep 2 · 5:00](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=300)
- "Patients who get a chest tube and fail in the hospital and subsequently go on to VATS still have a failure rate of around 25 to 30%" — Dan Osley (clinical) [Ep 2 · 5:24](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=324)
- "Patients who get immediate VATS have about a 10 to 15% failure rate" — Dan Osley (clinical) [Ep 2 · 8:02](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=482)
- "Patients who get a chest tube and then VATS have higher failure rates (25%) than those who get immediate VATS, possibly because they are predisposed to recurrence" — Dan Osley (clinical) [Ep 2 · 8:23](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=503)
- "The Society of Thoracic Surgery in adult patients recommends primary aspiration for spontaneous pneumothorax" — Dan Osley (guideline) [Ep 2 · 9:49](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=589)
- "In most large studies for primary spontaneous pneumothorax, the mean age is around 20 to 22 years, making this primarily a young adult disease" — Dan Osley (epidemiological) [Ep 2 · 9:49](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=589)
- "The average age in pediatric spontaneous pneumothorax studies has been between 15.5 and 16 years" — Dan Osley (epidemiological) [Ep 2 · 9:49](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=589)
- "The hole in spontaneous pneumothorax has probably already closed by the time patients come to the hospital" — Todd Ponsky (clinical) [Ep 2 · 10:27](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=627)
- "There is no published paper documenting tension physiology for spontaneous pneumothorax" — Todd Ponsky (clinical) [Ep 2 · 11:07](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=667)
- "Of 81 patients in retrospective study across 3 institutions over 13 years, none presented with tension physiology from spontaneous pneumothorax" — Dan Osley (clinical) [Ep 2 · 11:40](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=700)
- "In Midwest Consortium prospective study, 50% of patients who got aspiration failed within 6 hours" — Dan Osley (clinical) [Ep 2 · 14:22](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=862)
- "In the aspiration study, 33 patients presented across 9 institutions over 2 years" — Dan Osley (epidemiological) [Ep 2 · 14:39](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=879)
- "Of 17 patients who failed aspiration, 12 received chest tubes and 83% of those had persistent air leak requiring VATS or had recurrent pneumothorax" — Dan Osley (clinical) [Ep 2 · 15:50](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=950)
- "Of 5 patients who went directly to VATS after failed aspiration, none recurred" — Dan Osley (clinical) [Ep 2 · 16:38](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=998)
- "Of 16 patients who passed aspiration and went home, 40% came back with recurrent pneumothorax" — Dan Osley (clinical) [Ep 2 · 18:27](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1107)
- "The positive predictive value of aspiration in treating pneumothorax was 83% with negative predictive value of 56%" — Dan Osley (clinical) [Ep 2 · 18:39](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1119)
- "There is good data suggesting that pleurodesis is not beneficial in preventing recurrence of spontaneous pneumothorax" — Dan Osley (clinical) [Ep 2 · 23:27](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1407)
- "In three-institution retrospective data, patients who underwent VATS with pleurodesis had the same recurrence rate as those who underwent VATS alone" — Dan Osley (clinical) [Ep 2 · 23:48](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1428)
- "A large Chinese trial of 289 patients over 3 years (average age 22) randomized patients to wedge resection with or without mechanical pleurodesis using standardized sandpaper abrasion and showed identical recurrence rates" — Dan Osley (clinical) [Ep 2 · 24:20](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1460)
- "Chemical pleurodesis with talc is probably more effective than mechanical pleurodesis but creates a treacherous reoperative field" — Todd Ponsky (opinion) [Ep 2 · 25:13](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1513)
- "CT scans may identify blebs that are incidental findings in patients who never develop pneumothorax, similar to traumatic pneumatoceles that rarely rupture" — Dan Osley (clinical) [Ep 2 · 26:30](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1590)
- "For patients with multiple recurrences after VATS, thoracoscopic pleurectomy of parietal pleura from apex down to a couple ribs above diaphragm is performed" — Dan Osley (clinical) [Ep 2 · 27:31](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1651)
- "Pleurectomy is an arduous, bloody operation that is super painful for children, usually requiring epidurals, with patients hospitalized for a week or 10 days" — Dan Osley (clinical) [Ep 2 · 27:31](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1651)
- "For recurrent recurrent pneumothorax cases, talc pleurodesis would be used if available because it is an appropriate population where preventing reoperation is critical" — Dan Osley (opinion) [Ep 2 · 28:51](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1731)
- "Aerosolized talc comes in a can with a straw, is inserted down the trocar site, and when sprayed looks like it is snowing inside the chest" — Todd Ponsky (clinical) [Ep 2 · 29:31](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1771)
- "For small apical pneumothorax after pleurodesis where lung is fixed to chest wall and patient is asymptomatic, observation with repeat chest X-ray in 48 hours is appropriate rather than operation" — Dan Osley (clinical) [Ep 2 · 30:15](https://library.globalcastmd.com/watch/spontaneous-pneumothorax-1521?t=1815)
- "From the first quarter compared to the fourth quarter of the study, there was 74% less opioid use in Nuss procedures with cryoablation" (host_summary) [Ep 4 · 2:26](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=146)
- "80% of patients achieved early discharge home by postoperative day number 2 in the fourth quarter of the Nuss cryoablation study" (host_summary) [Ep 4 · 2:26](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=146)
- "The reduction in opioid use and length of stay was primarily related to discontinuing use of IV PCA during the study period" — Cecilia Gigena (host_summary) [Ep 4 · 2:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=166)
- "IV PCA does not seem to be necessary for Nuss procedures with cryoablation and can be eliminated fairly early in a surgeon's experience" — Cecilia Gigena (host_summary) [Ep 4 · 2:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=166)
- "The learning curve for cryoablation in Nuss procedures is not about technique but about pain protocols used around the time of surgery" — Cecilia Gigena (host_summary) [Ep 4 · 4:03](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=243)
- "Cryoablation implementation requires a protocol or regimen including pain team involvement preoperatively and postoperatively, with adjuncts such as gabapentin" — Cecilia Gigena (host_summary) [Ep 4 · 4:40](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=280)
- "Simple aspiration was successful in 33% of children with primary spontaneous pneumothorax" — Shawn St. Peter (host_summary) [Ep 4 · 6:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=375)
- "66% of children with primary spontaneous pneumothorax still required VATS after aspiration" — Shawn St. Peter (host_summary) [Ep 4 · 6:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=375)
- "Median length of stay with successful aspiration for pneumothorax was 20 hours (less than a day)" — Shawn St. Peter (host_summary) [Ep 4 · 6:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=375)
- "Median length of stay after VATS for pneumothorax was 3 days" — Shawn St. Peter (host_summary) [Ep 4 · 6:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=375)
- "For patients who went to VATS immediately after failed aspiration, median length of stay was 3.1 days, compared to 6 days for patients from the Midwest Pediatric Surgery Consortium" — Cecilia Gigena (host_summary) [Ep 4 · 7:02](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=422)
- "The entire treatment algorithm for spontaneous pneumothorax is split upon whether the patient is actively leaking air or had a bleb that popped and sealed" — Shawn St. Peter (clinical) [Ep 4 · 7:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=458)
- "Updated APSA guidelines for solid organ injury management use the APSA framework: Admission, Procedures, Set free (discharge), and Aftercare" — Em Gootee (host_summary) [Ep 4 · 8:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=526)
- "The most important change in the updated APSA guidelines is that discharge of a patient is not related to the severity of the injury but to the clinical condition of the patient" — Em Gootee (host_summary) [Ep 4 · 9:34](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=574)
- "Activity restriction for solid organ injuries should be for two weeks at first, then adjusted based on level of injury" — Em Gootee (host_summary) [Ep 4 · 10:02](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=602)
- "Solid organ injury management decisions should be based on clinical symptoms and signs of ongoing bleeding rather than solely on grade of injury" — Regan Williams (clinical) [Ep 4 · 10:48](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=648)
- "In the slipping rib syndrome study, 68 patients had rib resection without cryoablation (receiving other blocks), 22 had extrathoracic cryoablation, and 8 had slipping ribs resected as part of Nuss procedure" — Cecilia Gigena (host_summary) [Ep 4 · 11:53](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=713)
- "91% of cryoablation patients had cryoablation of T9 and T10 intercostal nerves with no documented abdominal wall laxity at 16-day follow-up" — Cecilia Gigena (host_summary) [Ep 4 · 13:10](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=790)
- "Patients who underwent rib excision with cryoablation used significantly less opioids in hospital compared to rib excision without cryoablation" — Cecilia Gigena (host_summary) [Ep 4 · 13:10](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=790)
- "Median length of stay was 1 day for patients with rib excision with cryoablation compared to 2 days for patients with rib excision without cryoablation" — Cecilia Gigena (host_summary) [Ep 4 · 13:10](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=790)
- "Visual analog scale pain scores were similar across all slipping rib syndrome groups, but opioid requirement was significantly less in the cryoablation group" — Crystal Lai (clinical) [Ep 4 · 13:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=837)
- "Abdominal wall laxity after T9 and T10 cryoablation was seen only once, in a pectus patient rather than a slipping rib patient" — Lisa McMahon (clinical) [Ep 4 · 14:27](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=867)
- "Patients with very low pectus deformities may have more discomfort in the lower costal margin area because it gets out of the field of T7 and T8 where most cryoablation is performed" — Cecilia Gigena (host_summary) [Ep 4 · 14:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-august-issue-2023-7977?t=886)
- "The study is a retrospective analysis from Children's Mercy Hospital in Kansas City examining spontaneous pneumothorax management." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "The study population included patients between 12 and 18 years old with spontaneous pneumothorax between 2016 and 2021." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "The institutional protocol was to start with simple aspiration and escalate to VATS if aspiration failed." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "The study included 59 patients total." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "33% of patients received simple aspiration as their treatment." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "66% of patients ended up receiving VATS." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "The aspiration group had a 45% recurrence rate." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "The aspiration group had a median length of stay of 20.4 hours." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "The VATS group had a 25% recurrence rate." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)
- "The VATS group had a median length of stay of 3.1 days." — Cecilia Gigena (host_summary) [Ep 3 · 0:00](https://library.globalcastmd.com/watch/management-of-primary-spontaneous-pneumothorax-in-children-7190?t=0)

## Changelog
- Sep 25: 4 items added automatically

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