title: Outcomes of outpatient treatment for primary spontaneous pneumothorax using a small-bore portable thoracic drainage device.
abstract: BACKGROUND
  There is no consensus regarding the initial intervention for primary spontaneous pneumothorax. We report the outcomes of outpatient treatment for primary spontaneous pneumothorax using a portable thoracic drainage device.
  
  
  METHODS
  Between April 2007 and December 2011, 99 consecutive patients with a first episode of primary spontaneous pneumothorax were indicated for insertion of a portable thoracic drainage device. All patients were treated with a small-bore portable thoracic drainage device that consists of a flexible 9F silicone catheter with one-way valves and a small plastic chamber. Successful treatment was defined as when the pneumothorax was resolved after the insertion of a portable thoracic drainage device solely on an outpatient basis. Demographic data and treatment outcomes were obtained by a retrospective chart review.
  
  
  RESULTS
  Ninety-seven patients (98%) with a first primary spontaneous pneumothorax were discharged from the emergency department after insertion of a portable thoracic drainage device. Ninety-three patients (94%) resolved with outpatient treatment. The median duration of portable thoracic drainage device insertion was 4 days (range, 0-33 days). The recurrence rate after treatment with a portable thoracic drainage device was 34% (32/93). There were two infections (2.0%), two instances of hemothoraces (2.0%), and one severe discomfort at the insertion site (1.0%). There were no cases of tension pneumothorax or reexpansion edema.
  
  
  CONCLUSIONS
  Outpatient treatment for primary spontaneous pneumothorax using a portable thoracic drainage device had a high success rate with few serious complications and an acceptable recurrence rate.
authors.affiliation: Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Karasaki
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Shizuya
authors.initials: S
authors.lastname: Shintomi
authors.affiliation: Department of Surgery, Asahi General Hospital, Asahi, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Nomura
authors.affiliation: Department of Surgery, Asahi General Hospital, Asahi, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Respiratory Medicine, Asahi General Hospital, Asahi, Japan.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Surgery, Asahi General Hospital, Asahi, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yoshida
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D057785:Catheters; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000175:diagnosis / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012828:Silicones; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012828:Silicones