[Pneumothorax].
Spontaneous idiopathic pneumothorax occurs frequently in young tall subjects with smoking habits, and is usually of good prognosis. Secondary pneumothorax is a life-threatening complication of an underlying lung disease, such as acute pneumonia. Pneumocystis carinii pneumonitis or chronic obstructive pulmonary disease. Short-term therapeutic options oppose non-traumatic needle aspiration, with a success rate of more than 50%, versus thoracic drainage, with a recurrence rate exceeding 35%. The existing literature also indicates that video-assisted surgery leads to a much better long-term prognosis than the standard drainage procedure, with a long-term recurrence rate of less than 2%, for equivalent hospital stays and complication rates. The widely accepted recommendation that surgery should be proposed only at the first or second pneumothorax recurrence may be challenged in the next decade.
Andrivet
Pierre
P
Département de réanimation cardio-respiratoire Centre médico-chirurgical de Bligny 91640 Briis-sous-Forges. p.andrivet@CM-bligny.com
D015505:Chest Tubes; D004322:Drainage; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D018579:Patient Selection; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome