Management of Primary Spontaneous Pneumothorax in Children
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- Simple aspiration first-line for pediatric spontaneous pneumothorax had 45% recurrence vs 25% with VATS in this retrospective study.
- Aspiration reduced hospital stay to 20 hours vs 3.1 days for VATS, but higher recurrence may offset initial length-of-stay benefit.
- Two-thirds of patients initially managed with aspiration ultimately required VATS, suggesting need for better patient selection criteria.
- Protocol of aspiration-first followed by VATS if failed is feasible but recurrence rates warrant discussion of upfront surgical approach.
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How do you manage spontaneous pneumothorax? Hi, I'm Cecilia Hihene from Cincinnati Children's Hospital, and I think this is an article that you should know about. This is a retrospective analysis done in Children's Mercy from Kansas City. They look at patients between 12 and 18 years old with spontaneous pneumothorax between 2016 and 2021. And what did they find? They gathered 59 patients, and their protocol was, start with a simple aspiration, and if it fails, go with BATS. Of their patients, 33% got a simple aspiration. 66% ended in BATS. In comparison, the aspiration group got a 45% of recurrence and a median length of state of 20.4 hours. While the BATS group got a 25% of recurrence and a median length of stay of 3.1 days. And you, how do you handle your spontaneous pneumothorax? Let us know what you think and stay tuned for more articles that you should know about.