title: ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax.
abstract: Primary spontaneous pneumothorax (PSP) affects young healthy people with a significant recurrence rate. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research.The European Respiratory Society's Scientific Committee established a multidisciplinary team of pulmonologists and surgeons to produce a comprehensive review of available scientific evidence.Smoking remains the main risk factor of PSP. Routine smoking cessation is advised. More prospective data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP, treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is available. Video-assisted thoracic surgery is preferred to thoracotomy as a surgical approach.In first episodes of PSP, aspiration is required only in symptomatic patients. After a persistent or recurrent PSP, definitive treatment including pleurodesis is undertaken. Future randomised controlled trials comparing different strategies are required.
authors.affiliation: Centre Valaisan de Pneumologie, Dept of Internal Medicine RSV, Montana, Switzerland Task Force Chairs jean-marie.tschopp@netplus.ch.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Tschopp
authors.affiliation: Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol, UK.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bintcliffe
authors.affiliation: Dept of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hospital North Aix-Marseille University, Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Astoul
authors.affiliation: Dept of Surgery, University of Rovira I Virgili, Tarragona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Canalis
authors.affiliation: Dept of Pneumology, AZ Turnhout, Turnhout, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Driesen
authors.affiliation: Dept of Pulmonary Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: Julius
authors.initials: J
authors.lastname: Janssen
authors.affiliation: Dept of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Marc
authors.initials: M
authors.lastname: Krasnik
authors.affiliation: Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Maskell
authors.affiliation: Dept of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Van Schil
authors.affiliation: Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland.
authors.forename: Thomy
authors.initials: T
authors.lastname: Tonia
authors.affiliation: Dept of Thoracic Surgery, Glenfield Hospital, Leicester, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Waller
authors.affiliation: Hospital Pasteur CHU Nice and Institute for Research on Cancer and Ageing, University of Nice Sophia Antipolis, Nice, France.
authors.forename: Charles-Hugo
authors.initials: CH
authors.lastname: Marquette
authors.affiliation: Dept of Thoracic Surgery, Carlo Forlanini Hospital, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy Task Force Chairs.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cardillo
mesh_terms: D026683:Advisory Committees; D051520:Antiperspirants; D006801:Humans; D018700:Pleurodesis; D011030:Pneumothorax / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery*; D017410:Practice Guidelines as Topic; D012008:Recurrence; D012907:Smoking / Q000009:adverse effects; D012955:Societies, Medical; D013627:Talc / Q000627:therapeutic use; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy
chemical_list: D051520:Antiperspirants; D013627:Talc