Comparison of Simple Manual Aspiration and Chest Tube Drainage in the First Occurrence of a Primary Spontaneous Pneumothorax

Oh, Sang Woo; Hyun, Sung Youl; Yang, Hyuk Jun; Lim, Yong Su; Kim, Jae Kwang; Lee, Gun

Abstract

PURPOSE
The aim of this prospective study was to determine the safety and the efficacy of simple manual aspiration, as an initial treatment for the first occurrence of a primary spontaneous pneumothorax, as opposed to chest tube drainage.
METHODS
From January 2002 to December 2002, 98 patients were admitted for the first occurrence of a primary spontaneous pneumothorax. They were divided into 3 groups according to sizes of the pneumothoraces and the treatment modalities: (1) size<25% (n=21; rest and oxygen therapy), (2) 2580% (n=20; chest tube drainage). Fifty-seven patients with pneumothorax size of 25 to 80% were randomly treated with simple manual aspiration (SMA; n=30) or with chest tube drainage (CTD; n=27).
RESULTS
The therapy was successful in 24 out of 30 patients (80.0%) in the SMA group and in 22 out of 27 patients (81.5%) in the CTD group (p=0.89). The recurrence rates at 3 months for the two groups were similar (6.7% and 11.1%, respectively; p =0.55). The hospital stay was significantly shorter in the SMA group than in the CTD group (4.2+/-3.27 and 7.5+/-2.77 days, respectively; p<0.01). Most of the treatment failures in the SMA group involved pneumothorax sizes greater than 50% (5 out of 6).
CONCLUSION
This study indicates that simple manual aspiration seems to be as effective and safe as chest tube drainage. Especially, simple manual aspiration may be proposed as a first-line treatment in the first occurrence of a primary spontaneous pneumothorax with a size smaller than 50%.