Volume 6, Issue 4, July 2020, Page: 56-60
Spontaneous Pneumothorax - Therapeutic Attitude - Brief Review
Claudiu-Eduard Nistor, Department of Thoracic Surgery, Central Military Emergency University Hospital “Carol Davila”, Bucharest, Romania
Adrian Ciuche, Department of Thoracic Surgery, Central Military Emergency University Hospital “Carol Davila”, Bucharest, Romania
Camelia Stanciu-Găvan, Department of Thoracic Surgery, Central Military Emergency University Hospital “Carol Davila”, Bucharest, Romania; Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
Received: Jul. 26, 2020;       Accepted: Aug. 14, 2020;       Published: Sep. 3, 2020
DOI: 10.11648/j.ijcts.20200604.12      View  174      Downloads  66
Abstract
Background: Spontaneous pneumothorax is a type of air collection in the pleural cavity that it develops in the absence of trauma or an iatrogenic cause. It may become an emergency in thoracic surgery. The anatomical substrate of spontaneous pneumothorax is represented by blisters. But we must not minimize the emphysema bubbles that appear in the lung parenchyma, which may also be a common cause of spontaneous pneumothorax. In order to appear the spontaneous pneumothorax, it is considered necessary to have an area of minimal resistance in the visceral pleura and also a triggering element. For decades, the therapeutic options are been discussed. Objectives: literature review and updating of scientific data Method: The management of conservative treatment is known, ambulatory air aspiration, drain tube installation, video-assisted thoracoscopic surgery The use of chemical pleurodesis - betadine versus talc and mechanical - pleural abrasion, resection of blisters or ligature at their base, apical pleurectomy, are therapeutic options that are custom applied for each case. The current diagnostic and treatment guidelines have been designed about 10 years ago and with a little change. Results: We support the use as a chemical agent of betadine to prevent recurrences with a similar effect to that of talc. We concluded that the introduction of betadine into the drain tube after minimal pleurotomy for symphysis, can sometimes lead to local pain, sometimes atrocious, unbearable, even simulating the myocardial infarction pain. Therefore, before applying the chemical, we recommend the systemic analgesics and local analgesic from the amide group. Video-assisted thoracic surgery is the main surgical technique for treating pneumothorax in order to prevent recurrences. Conclusions - We considered necessary a mini-revision of the literature in order to update the scientific data and the effective treatment methods with the mention of some own amendments regarding the therapeutic options.
Keywords
Spontaneous Pneumothorax, Thoracic Tube, Video Assisted Thoracoscopic Surgery, Chemical Pleurodesis
To cite this article
Claudiu-Eduard Nistor, Adrian Ciuche, Camelia Stanciu-Găvan, Spontaneous Pneumothorax - Therapeutic Attitude - Brief Review, International Journal of Cardiovascular and Thoracic Surgery. Vol. 6, No. 4, 2020, pp. 56-60. doi: 10.11648/j.ijcts.20200604.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Hany Hasan Elsayed, Chapter Indications of Surgery in Pneumothorax, Intech Open, 2019, DOI: http://dx.doi.org/10.5772/intechopen.88640.
[2]
Claudiu Nistor, Adrian Ciuche, Teodor Horvat, Capitol Spontaneous Pneumothorax: Treated Surgery, Thoracic Surgery, Ed Academia Romana, Vol IV, 2008, 261-269.
[3]
A. M. Rupperta, J. Perrin, A. Khalil, T. Vieiraa, D. Abou-Chedidc, H. Masmoudid, P. Crequita, M. Giol d, J. Cadranela, b, J. Assouadd, V. Gounanta; Effect of cannabis and tobacco on emphysema in patientes with spontaneous pneumothorax; Diagnostic and Interventional Imaging (2018) 99, 465—471; https://doi.org/10.1016/j.diii.2018.01.017.
[4]
Tania Marxa, b, f, Nadine Bernardb, c, f, Anne-Laure Parmentierb, d, f, Marc Puyrveaub, d, f, Berenger Martind, Madeleine Ganteletd, f, Jean-Baptiste Pretellia, Jean-Charles Dalphinb, e, f, Frédéric Maunyb, d, f, Thibaut Desmettrea; Does air pollution really impact the onset of spontaneous pneumothorax? A French case-crossover study; Environment International 127 (2019) 317–323.
[5]
Jean-Marie Tschopp, Oliver Bintcliffe, ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax, Eur Respir J 2015; 46: 321–335 | DOI: 10.1183/09031936.00219214.
[6]
Johnson MK, Smith RP, Morrison D, et al. Large long bullae in marijuana smokers. Thorax 2000; 55: 340–342.
[7]
Hussein Traboulsi, Mathew Cherian, Mira Abou Rjeili, Matthew Preteroti, Jean Bourbeau, Benjamin M. Smith, David H. Eidelman and Carolyn J. Baglle; Inhalation Toxicology of Vaping Products and Implications for Pulmonary Health; International Journal of Molecular Sciences; Int. J. Mol. Sci. 2020, 21, 3495; two: 10.3390/ijms21103495.
[8]
Tania Marxa, Nadine Bernardb, c, f, Anne-Laure Parmentierb, Marc Puyrveaub, d, f, Berenger Martind, Madeleine Ganteletd, f, Jean-Baptiste Pretallia, Jean-Charles Dalphinb, e, f, Frédéric Maunyb, d, f, Thibaut Desmettrea; Does air pollution really impact the onset of spontaneous pneumothorax? A French case-crossover study; Environment International 127 (2019) 317–323.
[9]
Borja Aguinagalde, Jose ́ Luis Aranda, Pablo Busca, Ivan Martinez, Inigo Royo, Jon Zabaleta, a Working Group of the CPG for the Management of Patients with Spontaneous; SECT Clinical Practice Guide on the Management of Patients With Spontaneous Pneumothorax; CIRUGI ́A ESPAN AND OLA; cir esp. 2 0 1 8; 96 (1): 3–11.
[10]
Scott RM, Henske EP, Raby B, Boone PM, Rusk RA, Marciniak SJ. Family pneumothorax: towards precision medicine. Thorax. 2018; 73: 270-6.
[11]
E. Dias, I. Farinha, F. Costa; Alpha-1-antitrypsin deficiency (AATD) and spontaneous pneumothorax: Guidelines do not recommend screening for AATD in patientes with pneumothorax --- What did we find in 10 years of clinical evidence?/ PULMONOMY-2020, 1501; https://doi.org/10.1016/j.pulmoe.2020.05.014.
[12]
Boone PM, Scott RM, Marciniak SJ, Henske EP, Raby BA. The genetics of pneumothorax. I J Respir Crit Care Med. 2019; 199 (S1): 1344---57.
[13]
Karima Sajadi-Ernazarova, Jennifer Martin, Nagendra Gupta; Acute Pneumothorax Evaluation and Treatment; 3/16/2020.
[14]
Soldiers G, Testa A, Sher S, et al. Occult traumatic pneumothorax: diagnosis accuracy of long ultrasound in the emergency department. Chest 2008; 133: 204–211.
[15]
MacDuff A, Arnold A, Harvey J. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010; 65 (Suppl 2): ii18-ii31.
[16]
Huang Y, Huang H, Li Q, Browning RF, Parrish S, Turner JF Jr, Zarogoulidis K, Kougioumtzi I, Dryllis G, Kioumis I, Pitsiou G, Machairiotis N, Katsikogiannis N, Courcoutsakis N, Madesis A, Diplaris K, Karaiskos T, Zarogoulidis P, Approach of the treatment for pneumothorax. Journal of thoracic disease. 2014 Oct [PubMed PDID: 25337397].
[17]
Min Joung Kim, Incheol Park, Joon Min Park, Kyung Hwan Kim, Junseok Park, Dong Wun Shin; Systematic review and meta-analysis of initial management of pneumothorax in adults: Intercostal tube draining versus other invasive methods; PLoS ONE, 2017; 12 (6): e0178802. https://doi.org/10.1371/journal.pone.0178802.
[18]
Fabian Andres Giraldo Vallejo, Rubby Romero, Melissa Mejia and Estefania Quijano; Chapter Primary Spontaneous Pneumothorax, a Clinical Challenge; We are Intech Open, the world's healing publisher of Open Access books Built by scientists, for scientists; 2019 DOI: http://dx.doi.org/10.5772/intechopen.83458.
[19]
Andrew MacDuff, Anthony Arnold, John Harvey, on behalf of the BTS Pleural Disease Guideline Group, Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010, BTS guidelines, Thorax 2010; 65 (Suppl 2): ii4ei17. two: 10.1136/thx.2010.136978.
[20]
Shi-ping LUH, Review: Diagnosis and treatment of primary spontaneous pneumothorax; Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2010, Luh / J Zhejiang Univ-Sci B (Biomed & Biotechnol) 2010 11 (10): 735-744; ISSN 1673-1581 (Print); ISSN 1862-1783 (Online); www.zju.edu.cn/jzus; www.springerlink.com.
[21]
Ciuche A, Nistor Cl, Pantile D, Marin D, Tudose A. Spontaneous pneumothorax in a case of pulmonary Langerhans Cell Histiocytosis.; Mædica - a Journal of Clinical Medicine, vol 6 No 3, 2011; 204-209.
[22]
Joshua D. Stodghill, Devon T. Collins, Amit K. Mahajan, Sandeep J. Khandhar; Review Article Primary spontaneous pneumothorax: A pathway to practice; AME Medical Journal; 2019; 4: 8; two: 10.21037/amj.2018.11.05.
[23]
Nistor, Cl.; Ciuche, A.; Davidescu, M.; Horvat, T., Pleurotomy - a surgical intervention at the hand of the general surgeon; 2009 Surgery, 104 (3): 323-328).
[24]
Apostolos Gogakos and all; Heimlich valve and pneumothorax; Annals of Translational Medicine; Ann Transl Med 2015; 3 (4): 54; two: 10.3978/j.issn.2305-5839.2015.03.25.
[25]
LTC Jacob Chen, Capt Roy Nadler, Maj Dagan Schwartz, Col Homer Tien, LTC Andrew P. Cap, Col Elon Glassberg; Needle thoracostomy for tension pneumothorax: the Israeli Defense Forces experience; J can chir, Vol. 58 (No 3 Suppl 3) June 2015; DOI: 10.1503/cjs.012914.
[26]
Claudiu Nistor, Aurelian-Emil Ranetti, Adrian Ciuche, Daniel Pantile, Laura–Mariana Constantin, Roxana Brincoveanu; Betadine in Chemichal Pleurodesis; Pharmacy, 2014, Vol. 62, 5, 897-907.
[27]
Shah-Hwa Chou, corresponding, Hsien-Pin Li, Yen-Lung Lee, Jui-Ying Lee, Hung-Hsing Chiang, Dong-Lin Tsai, Meei-Feng Huang, and Tsun-En Lin; Video-assisted thoracoscopic surgery for postoperative recurrence primary spontaneous pneumothorax; Journal of Thoracic Disease, 2014 Jan; 6 (1): 52–55; two: 10.3978/j.issn.2072-1439.2014.01.09.
[28]
R J Hallifax, A Yousuf, H E Jones, J P Corcoran, I Psallidas, N M Rahman; Effectiveness of chemical pleurodesis in spontaneous pneumothorax recurrence prevention: a systematic review; Respiratory research; BMJ, Thorax 2017; 72: 1121–1131; two: 10.1136/thoraxjnl-2015-207967.
[29]
José M. Porcel; Chest Tube Draining of the Pleural Space: A Concise Review for Pulmonologists; Tuberc Respir Dis 2018; 81: 106-115; https://doi.org/10.4046/trd.2017.0107.
[30]
Adrian CIUCHE; Claudiu NISTOR; Daniel PANTILE; Teodor HORVAT; Minimally Invasive Surgical Treatment of Malignant Pleural Effusions; Mædica - a Journal of Clinical Medicine; Volume 6 No. 4 2011; 262-267.
[31]
Xu W, Wang Y, Song J, Mo L, Jiang T. One-port video-assisted thoracic surgery versus three-port videoassisted thoracic surgery for primary spontaneous pneumothorax: A metaanalysis. Surgical Endoscopy. 2017 Jan; 31 (1): 17-24.
[32]
Caecilia Ng; Herbert Thomas Maier; Florian Kocher; Silvia Jud; Paolo Lucciarini; Dietmar O Ø fner; Thomas Schmid; Florian Augustin; VATS Partial Pleurectomy Versus VATS Pleural Abrasion: Significant Reduction in Pneumothorax Recurrence Rates After Pleurectomy; World J Surg (2018) 42: 3256–3262; https://doi.org/10.1007/s00268-018-4640-8.
[33]
Darcy Ribeiro Pinto Filho, Bruno Mayeri Pinto, Vitor Mayeri Pinto; Primary spontaneous pneumothorax (PSP): the role of VATS and a new paradigm; Sping Technique on Thoracic Surgery; Journal of Visualized Surgery; 2019; 5: 27; two: 10.21037/jovs.2019.02.04.
[34]
Lazopoulos A, Barbetakis N, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, et al. Open thhoracotomy for pneumothorax. Journal of Thoracic Disease. 2015; 7: 6.
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