Primary spontaneous pneumothorax in pediatric patients: our 7-year experience.
BACKGROUND
Primary spontaneous pneumothorax in children is a significant clinical problem. The majority of these patients will require immediate surgical therapy, such as tube thoracostomy.


METHODS
We conducted a retrospective review of 16 patients with a diagnosis of primary spontaneous pneumothorax over a period of 7 years.


RESULTS
In the last 7 years, we had 16 patients with spontaneous pneumothorax. Patient age ranged from 11 to 18 years (median, 15.4). We had 12 boys and 4 girls. Pneumothorax occurred on the right side in 9 patients, on the left side in 6 patients, and on both sides in 1 patient. The first choice of treatment was tube thoracostomy. The main symptoms were chest pain, shortness of breath, and cough. In all patients, we made X-ray and computed tomography scan. In 10 children, we detected apical bullas; in 2 patients, we found giant bullas in the lower part of the lung. In 4 patients, we did not find any pathologic signs on the lung. Two patients with spontaneous pneumothorax had tube drainage without recurrence. Eleven patients were operated on with video-assisted thoracoscopic surgery (VATS). Three patients were operated with open thoracotomy. Two of them had giant bullas, and 1 patient had recurrence after VATS. One patient had pneumothorax on both sides of the pleural cavity.


CONCLUSIONS
VATS is an effective, safe method for spontaneous pneumothorax in children. In 11 children with pneumothorax, we made a wedge resection of the apical part of the lung with an endostapler device plus mechanical pleurodesis.
Zganjer
Mirko
M
Department of Pediatric Surgery, Children's Hospital Zagreb, Zagreb, Croatia. mirko.zganjer@zg.htnet.hr
Cizmić
Ante
A
Pajić
Anto
A
Cigit
Irenej
I
Zganjer
Vlasta
V
D000293:Adolescent; D000465:Algorithms; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011030:Pneumothorax / Q000175:diagnosis / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013907:Thoracostomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome