[Idiopathic spontaneous pneumothorax: treatment by small-caliber catheter aspiration compared to drainage through a chest tube]. / Neumotórax espontáneo idiopático: tratamiento basado en la aspiración con catéter fino frente a drenaje torácico.

ABSTRACT

BACKGROUND: Several options are available for treating patients with a first episode of primary spontaneous pneumothorax (ISP). The aim of this study was to compare the efficacy of two treatment alternatives puncture-aspiration (PA) using a small caliber catheter, and pleural drainage through a chest tube (DCT). PATIENTS AND METHODS: We compared a current series of 91 patients treated with PA with a retrospective series of 216 patients treated with DCT. PA was performed by emergency room physicians and DCT was performed by chest surgeons. Patients were followed for a period of 24 months. RESULTS: The immediate efficacy of PA was superior to DCT (86.7% versus 76%, p < 0.05). The proportion of recurrences after each treatment was similar (23% and 17%, respectively, NS). Duration of hospital stay was shorter for PA-treated patients (24 h) than for DCT-treated patients (138 h) (p < 0.05). The efficacy of the two procedures 24 months later was similar (63.7% and 62.9%, respectively, NS), and the cost of PA was three times less than that of DCT. CONCLUSIONS: PA is as effective a treatment procedure as DCT. PA is simple enough for emergency room physicians to perform correctly. Inconvenience to the patient, cost to the health care system, and time of hospital stay are all significantly less with PA.