Efficacy of blebs detection for preventive surgery in children's idiopathic spontaneous pneumothorax.
BACKGROUND
This retrospective, single-center study was designed to assess our management strategy based on blebs detection on the initial CT scan.


METHODS
Children younger than aged 18 years presenting with a primary spontaneous pneumothorax (PSP) between 2000 and 2007 in a University Children's Hospital (hospital Armand Trousseau, Paris, France) were included in this study.


RESULTS
Twenty-five children who presented with PSP were included. The mean age was 14.2 +/- 1.9 years, and the sex ratio was 2.1. There was no significant difference between patients with or without blebs with regard to the anthropomorphic data or the side of the pneumothorax. Six patients had recurrence, which, in most cases, was a grade 1 pneumothorax. Fourteen (56%) children showed blebs on CT scan, which was ipsilateral or bilateral in 13 cases and contralateral in 1 case. Eleven of these children had surgery, and all the remaining patients (n = 3) had recurrence. All the patients, except one, presenting blebs on the preoperating CT scan, showed blebs on the subsequent surgery (predictive positive value = 92%), and the CT-scan sensibility for blebs was 75%.


CONCLUSIONS
In children, blebs detection on CT scan has a good sensitivity and may be a useful tool to determine the indication of lung surgery to prevent PSP recurrence.
Nathan
Nadia
N
Hôpital Armand Trousseau, Université Pierre et Marie Curie-Paris 6, 26 avenue du docteur Arnold Netter, Paris Cedex 12, France. nadia.nathan@trs.aphp.fr
Guilbert
Julia
J
Larroquet
Michèle
M
Lenoir
Marion
M
Clement
Annick
A
Epaud
Ralph
R
D000293:Adolescent; D001768:Blister / Q000000981:diagnostic imaging* / Q000601:surgery*; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000517:prevention & control / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed