title: Management of primary spontaneous pneumothorax in children.
abstract: OBJECTIVE
  To examine the role of CT scans and early surgical intervention in the management of pediatric patients with primary spontaneous pneumothorax (PSP).
  
  
  METHODS
  Retrospective cohort study.
  
  
  RESULTS
  The authors identified 46 cases with 70 episodes of pneumothorax. The recurrence rate among conservatively treated patients was 50% both after the first and the subsequent episode. Recurrence rate in cases with and without blebs on CT was comparable. Initial episodes were treated with supplemental oxygen (n = 18) and chest tube drainage (n = 18), and 10 patients underwent video-assisted thoracoscopic surgery (VATS). The recurrence rate was significantly lower following surgical intervention compared with other therapy, and morbidity was comparable with that in patients who needed chest tube drainage.
  
  
  CONCLUSIONS
  Recurrence after the first episode of PSP in children is frequent and is difficult to predict by CT findings. VATS is safe and effective in preventing recurrences. Surgical intervention may be an attractive alternative in patients who require chest tube drainage for the first episode of PSP.
authors.affiliation: Assaf Harofe Medical Center, Zerifin, Israel.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Seguier-Lipszyc
authors.forename: Arnon
authors.initials: A
authors.lastname: Elizur
authors.forename: Baruch
authors.initials: B
authors.lastname: Klin
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.forename: Gad
authors.initials: G
authors.lastname: Lotan
mesh_terms: D000293:Adolescent; D015505:Chest Tubes; D002648:Child; D015331:Cohort Studies; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D010102:Oxygen Inhalation Therapy; D011030:Pneumothorax / Q000150:complications / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000628:therapy*; D012189:Retrospective Studies; D055502:Secondary Prevention; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed