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Review

Pathogenesis and Treatment of Primary Spontaneous Pneumothorax: An Overview

Noppen M.a · Baumann M.H.b

Author affiliations

aInterventional Endoscopy Clinic, Academic Hospital AZ-VUB, Brussels, Belgium; bDivision of Pulmonary and Critical Care Medicine, University of Mississippi Medical Center, Jackson, Miss., USA

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Respiration 2003;70:431–438

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Article / Publication Details

First-Page Preview
Abstract of Review

Received: October 14, 2002
Accepted: February 24, 2003
Published online: September 17, 2003
Issue release date: July – August

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 1

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

The exact pathogenesis of primary spontaneous pneumothorax (PSP) remains unknown. Furthermore, various specialists including pulmonologists, surgeons, emergency care physicians, radiologists and others are known to treat this disorder in clinical practice. As a consequence, guidelines on the management of PSP are scarce, and differences in treatment approaches persist. In this paper, evidence on the pathogenesis and on various treatment techniques and strategies is reviewed. An algorithmic treatment approach is proposed.

© 2003 S. Karger AG, Basel


References

  1. Noppen M, Schramel F: Pneumothorax. Eur Respir Rev 2002;7:279–296.
  2. Light RW: Pneumothorax. Pleural diseases. Philadelphia, Lippincott/Williams & Wilkins, 2001, pp 284–319.
  3. Sahn SA, Heffner JE: Spontaneous pneumothorax. N Engl J Med 2000;342:868–874.
  4. Melton LJ III, Hepper NNG, Offord KP: Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974. Am Rev Respir Dis 1979;120:1379–1382.
  5. Bense L, Eklund G, Wiman LG: Smoking and the increased risk of contracting spontaneous pneumothorax. Chest 1987;92:1009–1012.
  6. Miller AC, Harvey J: Guidelines for the management of spontaneous pneumothorax. BMJ 1993;307:114–116.
  7. Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D: Epidemiology of pneumothorax in England. Thorax 2000;55:666–671.
  8. Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, Luketich JD, Panacek EA, Sahn SA: Management of spontaneous pneumothorax. An American College of Chest Physicians. Delphi Consensus Statement. Chest 2001;119:590–602.
  9. Baumann MH, Strange C: The clinicians perspective on pneumothorax management. Chest 1997;112:822–828.
  10. Janssen JP, Cuesta MA, Postmus PE: Behandeling van spontane pneumothorax: Enquête onder Nederlandse longartsen. Ned Tijdschr Geneeskd 1994;138:661–664.
  11. Jutley RS, Mason R, Cockburn JS: Discrepancies in the detection and management of spontaneous pneumothorax: Eight years after publication of guidelines. Scot Med J 2001;46:111–113.
  12. Mendis D, El-Shanawany T, Mathur A, Redington AE: Management of spontaneous pneumothorax: Are British Thoracic Society guidelines being followed? Postgrad Med J 2002;78:80–84.
  13. Baumann MH, Strange C: Treatment of spontaneous pneumothorax. A more aggressive approach? Chest 1997;112:789–804.
  14. Light RW: Management of spontaneous pneumothorax. Am Rev Respir Dis 1993;148:245–248.
  15. Northfield TC: Oxygen therapy for spontaneous pneumothorax. BMJ 1971;4:86–88.
  16. Noppen M, Alexander P, Driesen P, Slabbynck H, Verstraeten A: Qualification of the size of primary pneumothorax: Accuracy of the Light index. Respiration 2001;68:396–399.
  17. Schramel JFMN, Postmus PE, Vanderschueren RG: Current aspects of spontaneous pneumothorax. Eur Respir J 1997;10:1372–1379.
  18. Light RW, O’Hara VS, Moritz TE, et al: Intrapleural tetracycline for the prevention of recurrent spontaneous pneumothorax: Results of a Department of Veteran Affairs cooperative study. JAMA 1990;264:2224–2230.
  19. Lippert HL, Lund O, Blegvad S, et al: Independent risk factors for cumulative recurrence rate after first spontaneous pneumothorax. Eur Respir J 1991;4:324–331.
  20. British Thoracic Society Research Committee: Comparison of simple aspiration with intercostal drainage in the management of spontaneous pneumothorax. Thorax 1993;48:430–431.
  21. Gobbel WG Jr, Rhea WG Jr, Nelson IA, et al: Spontaneous pneumothorax. J Thorac Cardiovasc Surg 1963;46:331–345.
  22. Ruckley CV, Mc Cormack RJM: The management of spontaneous pneumothorax. Thorax 1966;21:139–144.
  23. Schramel FM, Sutedja TG, Braber JC, Van Mourik JC, Postmus PE: Cost-effectiveness of video-assisted thoracic surgery versus conservative treatment for first time or recurrent spontaneous pneumothorax. Eur Respir J 1996;9:1821–1825.
  24. Torresini G, Vaccarili M, Divisi D, Crisci R: Is video-assisted thoracic surgery justified at first spontaneous pneumothorax? Eur J Cardiothorac Surg 2001;20:42–45.
  25. Noppen M. Management of primary spontaneous pneumothorax: Does cause matter? Monaldi Arch Dis Chest 2001;56:344–348.
  26. British Thoracic Society Research Committee: Comparison of simple aspiration with intercostal drainage in the management of spontaneous pneumothorax. Thorax 1993;48:430–431.
  27. Andrivet P, Djedaini K, Teboul J, et al: Spontaneous pneumothorax: Comparison of thoracic drainage versus immediate or delayed needle aspiration. Chest 1995;108:335–340.
  28. Noppen M, Alexander P, Driesen P, Slabbynck H, Verstraeten A: Manual aspiration versus chest tube drainage in first episodes of primary spontaneous pneumothorax. A multicenter, prospective, randomized pilot study. Am J Respir Crit Care Med 2002;165:1240–1244.
  29. Light RW: Manual aspiration: The preferred method for managing primary spontaneous pneumothorax? Am J Respir Crit Care Med 2002;165:1202–1203.
  30. Van de Brekel JA, Duurkens VAM, Vanderschueren RGJRA: Pneumothorax. Results of thoracoscopy and pleurodesis with talc poudrage and thoracotomy. Chest 1993;103:345–347.
  31. Noppen M: Con: Blebs are not the cause of primary spontaneous pneumothorax. J Bronchol 2002;9:319–325.
    External Resources
  32. Masshof W, Höfer W: Zur pathologie des sogenannten idiopathischen Spontanpneumothorax. Dtsch Med Wschr 1973;98:801–805.
  33. Liu HP, Chang CH, Lin PJ, Chu JJ, Hsieh MJ: An alternative technique in the management of bullous emphysema. Thoracoscopic endoloop ligation of bullae. Chest 1997;111:489–493.
  34. Liu HP, Lin PJ, Hsieh MJ, Chang JP, Chang CH: Thoracoscopic surgery as a routine procedure for spontaneous pneumothorax. Results from 82 patients. Chest 1995;107:559–562.
  35. Waller DA, Forty J, Morritt GN: Video-assisted thoracic surgery versus thoracotomy for spontaneous pneumothorax. Am Thorac Surg 1994;58:372–376.
  36. Kim KH, Kim HK, Han JY: Transaxillary minithoracotomy versus video-assisted thoracic surgery for spontaneous pneumothorax. Am Thorac Surg 1996;61:1510–1512.
  37. Miller JD, Simone C, Kahnamoui K, Thomas J, Bennett WF, Young JEM, Urschel JD: Comparison of videothoracoscopy and axillary thoracotomy for the treatment of spontaneous pneumothorax. Ann Surg 2000;66:1014–1015.
  38. Hyland MJ, Ashrafi AS, Crépeau A, Mehzan RJ: Is video-assisted thoracoscopic surgery superior to limited axillary thoracotomy in the management of spontaneous pneumothorax? Can Respir J 2001;8:339–343.
  39. Baumann MH: Pro: Blebs are the cause of primary spontaneous pneumothorax. J Bronchol 2002;9:314–318.
  40. Swierenga J,Wagenaar JPM, Bergstein PGM: The value of thoracoscopy in the diagnosis and treatment of diseases affecting pleura and lung. Pneumologie 1974;151:11–18.
  41. Guérin JC, Chambel F, Biron E, Kalb JC: Talcage pleural par thoracoscopie dans le traitement du pneumothorax. Rev Mal Respir 1985;2:25–29.
  42. Almind M, Lange P, Viskum K: Spontaneous pneumothorax: Comparison of simple drainage, talc pleurodesis, and tetracycline pleurodesis. Thorax 1989;44:627–630.
  43. Boutin C, Viallat JR, Aelony Y: Practical Thoracoscopy. Berlin, Springer, 1991.
  44. Olsen PS, Orbaeck Andersen H: Long-term results after tetracycline pleurodesis in spontaneous pneumothorax. Ann Thorac Surg 1992;53:1015–1017.
  45. Bense L, Iewander R, Eklund G, Hendenstierna G, Wiman L: Nonsmoking, non- alpha-1-antitrypsin deficiency-induced emphysema in nonsmokers with healed spontaneous pneumothorax, identified by computed tomography of the lung. Chest 1993;103:433–438.
  46. Lesur O, Delorme N, Fromaget JM, et al: Computed tomography in the etiologic assessment of idiopathic spontaneous pneumothorax. Chest 1990;98:341–347.
  47. Donahue DM, Wright CD, Viale G, et al: Resection of pulmonary blebs and pleurodesis for spontaneous pneumothorax. Chest 1993;104:1767–1769.
  48. Mitlehner W, Friedrich M, Dissmann W: Value of computed tomography in the detection of bullae and blebs in patients with primary spontaneous pneumothorax. Respiration 1992;59:221–227.
  49. Warner B, Bailey W, Shipley T: Value of computed tomography of the lung in the management of primary spontaneous pneumothorax. Am J Surg 1991;162:39–42.
  50. Weissberg D, Rafaely Y: Pneumothorax. Experience with 1,199 patients. Chest 2000;117:1279–1285.
  51. Randomsky J, Becker HP, Hartel W: Pleuraporosität beim idiopatischen Spontanpneumothorax. Pneumologie 1989;43:250–253.
  52. Hatz RA, Kaps MF, Meimarakis G, et al: Long-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax. Ann Thorac Surg 2000;70:253–257.
  53. Körner H, Andersen KS, Stangeland, et al: Surgical treatment of spontaneous pneumothorax by wedge resection without pleurodesis or pleurectomy. Eur J Cardio-Thorac Surg 1996;10:656–659.
  54. Loubani M, Lynch V: Video-assisted thoracoscopic bullectomy and acromycin pleurodesis: An effective treatment for spontaneous pneumothorax. Resp Med 2000;94:888–890.
  55. Horio H, Nomori H, Kobayaski R, Narube T, Suemasu K: Impact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax. Surg Endosc 2002;16:630–634.
    External Resources
  56. Tschopp JM, Brutsche M, Frey JG: Treatment of complicated spontaneous pneumothorax by simple talc pleurodesis under thoracoscopy and local anaesthesia. Thorax 1997;52:329–332.
  57. Noppen M, Meysman M, D’Haese J, et al: Comparison of video-assisted thoracoscopic talcage for recurrent primary versus persistent secondary spontaneous pneumothorax. Eur Respir J 1997;10:412–416.
  58. Cottin V, Streichenberger N, Gamondes JP, Thevenet F, Loire R, Cordier JF: Respiratory bronchiolitis in smokers with spontaneous pneumothorax. Eur Respir J 1998;12:702–704.
  59. Ohata M, Suzuki H: Pathogenesis of spontaneous pneumothorax. With special reference to the ultrastructure of emphysematous bullae. Chest 1980;77:771–776.
  60. Schramel FMNH, Meyer CJLM, Postmus PE: Inflammation as cause of spontaneous pneumothorax and emphysema-like changes: Results of bronchoalveolar lavage. Eur Respir J 1995;8:397s.
  61. Lichter I, Gwynne JF: Spontaneous pneumothorax in young subjects. A clinical and pathological study. Thorax 1971;26:409:417.
  62. Morrison P, Lowry R, Nevin N: Familial primary spontaneous pneumothorax consistent with true autosomal dominant inheritance. Thorax 1998;53:151–152.
  63. Bense L, Eklund G, Wiman LG: Bilateral bronchial anomaly. A pathogenic factor in spontaneous pneumothorax. Am Rev Respir Dis 1992;146:513–516.
  64. Scott GC, Berger R, McKean HE: The role of atmospheric pressure variation in the development of spontaneous pneumothorax. Am Rev Respir Dis 1989;139:659–662.
  65. Tschopp JM, Boutin C, Astoul P, Janssen JP, Grandin S, Bolliger CT, Delaunois L, Driesen P, Tassi G, Perruchaud AP: Talcage by medical thoracoscopy for primary spontaneous pneumothorax is more cost-effective than drainage: A randomised study. Eur Respir J 2002;20:1003–1009.
  66. Passlick B, Born C, Mandelkow H, Sienel W, Thetter O: Long-term complaints after minimal invasive thoracic surgery operations and thoracotomy. Chirurg 2001;72:934–983.
  67. Passlick B, Born C, Sienel W, Thetter O: Incidence of chronic pain after minimal-invasive surgery for spontaneous pneumothorax. Eur J Cardiothorac Surg 2001;19:335–338.
    External Resources
  68. Leo F, Pastorino V, Goldstraw P: Pleurectomy in primary pneumothorax: Is extensive pleurectomy necessary? J Cardiovasc Surg 2000;411:633–636.
  69. Almind M, Lange P, Viskum K: Spontaneous pneumothorax: Comparison of simple drainage, talc pleurodesis, and tetracycline pleurodesis. Thorax 1989;44:627–630.
  70. Colt HG, Russack V, Chin Y, Konopka RG, Chiles PG, Pedersen CA, Kapelanski D: A comparison of thoracoscopic talc insufflation, slurry and mechanical abrasion pleurodesis. Chest 1997;111:442–448.
  71. Berger R: Pleurodesis for spontaneous pneumothorax: Will the procedure of choice please stand up? Chest 1994;106:992–994.
  72. Light RW, O’Hara VS, Moritz TE, et al: Intrapleural tetracycline for the prevention of recurrent spontaneous pneumothorax. Results of a Department of Veterans Affairs cooperative study. JAMA 1990;264:2224–2230.
  73. Alfageme I, Moreno L, Huertas C, Vargas A, Hernandez J, Beiztegui A: Spontaneous pneumothorax. Long-term results with tetracycline pleurodesis. Chest 1994;106:347–350.
  74. Cardillo G, Facciolo F, Giunti R, Gasparri R, Lopergolo M, Orsetti R, Martelli M: Videothoracoscopic treatment of primary spontaneous pneumothorax: A 6-year experience. Ann Thoracic Surg 2000;69:357–361.
  75. Loddenkemper R, Boutin C: Thoracoscopy: Present diagnostic and therapeutic indications. Eur Respir J 1993;6:1544–1545.
  76. Milanez de Campos JR, Vargas FS, de Campos Werebe E, Cardiso P, Teixeira LR, Jatene FB, Light RW: Thoracoscopy talc poudrage. A 15-year experience. Chest 2001;119:801–806.
  77. Delaunois L, El Khawand C: Medical thoracoscopy in the management of pneumothorax. Monaldi Arch Chest Dis 1998;53:148–150.
  78. Boutin C, Astoul P, Rey F, Mathur PN: Thoracoscopy in the diagnosis and treatment of spontaneous pneumothorax. Clin Chest Med 1995;16:497–503.
  79. Bresticker HA, Oba J, LoCicero J, Greene R: Optimal pleuriodesis: A comparison study. Ann Thoracic Surg 1993;55:364–367.
  80. Tschopp JM, Bolliger CT, Boutin C: Treatment of spontaneous pneumothorax: Why not simple talc pleurodesis by medical thoracoscopy? Respiration 2000;67:108–111.

Article / Publication Details

First-Page Preview
Abstract of Review

Received: October 14, 2002
Accepted: February 24, 2003
Published online: September 17, 2003
Issue release date: July – August

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 1

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES


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