초록접수 현황
| 16F-136 | 구연 발표 |
The Effectiveness of Manual Aspiration as an Initial Treatment for a First Episode of Primary Spontaneous Pneumothorax: a Prospective Randomized Trial
Do Kyun Kang, In Ha Kim, Ji Yong Kim, Woon Heo, Ho-ki Min, Hee Jae Jun, Youn-Ho Hwang
Department of Thoracic and Cardiovascular Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan Korea
Background : Pneumothorax is a common disease, however, its initial treatment remains controversial. We designed a prospective randomized trial to evaluate the effectiveness of manual aspiration as an initial treatment for a first episode of primary spontaneous pneumothorax(PSP).
Methods : Patients with first episodes of PSP more than 25% in size were recruited from December 2015 to June 2016. Patients were prospectively randomized at the time of admission to receive manual aspiration or tube thoracostomy. 40 patients were included in this study. Success for manual aspiration was defined as a complete or nearly complete and persistent lung expansion more than 12 hours after aspiration. Success for tube thoracostomy was defined as a complete lung expansion without air leakage and chest tube removal within 5 days after tube thoracostomy. When first manual aspiration failed, second attempt was performed. When second attempt failed, patients underwent tube thoracostomy. Patients with persistent air leakage more than 5 days after tube thoracostomy underwent surgical treatment in both groups.
Results : There were 21 patients in manual aspiration group and 19 patients in tube thoracostomy group. There was no difference between two groups in patients’ characteristics. The success rate was 81.0%(17/21) for manual aspiration group and 63.2%(12/19) for tube thoracostomy group. The difference was not statistically significant (p=0.16). In 10 patients of manual aspiration group, first manual aspiration failed. In 6 patients of these, second attempt was successful, but the other 4 patients underwent tube thoracostomy after failed second manual aspiration. Mean hospital stay of manual aspiration group was significantly shorter than those of tube thoracostomy group(2.1±1.8 vs 5.4±3.6days, p<0.01).
Conclusion : In the patients with first episodes of PSP, manual aspiration seems similarly effective as tube thoracostomy and it might decrease duration of hospital stay. Therefore, manual aspiration would be considered as an initial treatment for first episodes of PSP.
Methods : Patients with first episodes of PSP more than 25% in size were recruited from December 2015 to June 2016. Patients were prospectively randomized at the time of admission to receive manual aspiration or tube thoracostomy. 40 patients were included in this study. Success for manual aspiration was defined as a complete or nearly complete and persistent lung expansion more than 12 hours after aspiration. Success for tube thoracostomy was defined as a complete lung expansion without air leakage and chest tube removal within 5 days after tube thoracostomy. When first manual aspiration failed, second attempt was performed. When second attempt failed, patients underwent tube thoracostomy. Patients with persistent air leakage more than 5 days after tube thoracostomy underwent surgical treatment in both groups.
Results : There were 21 patients in manual aspiration group and 19 patients in tube thoracostomy group. There was no difference between two groups in patients’ characteristics. The success rate was 81.0%(17/21) for manual aspiration group and 63.2%(12/19) for tube thoracostomy group. The difference was not statistically significant (p=0.16). In 10 patients of manual aspiration group, first manual aspiration failed. In 6 patients of these, second attempt was successful, but the other 4 patients underwent tube thoracostomy after failed second manual aspiration. Mean hospital stay of manual aspiration group was significantly shorter than those of tube thoracostomy group(2.1±1.8 vs 5.4±3.6days, p<0.01).
Conclusion : In the patients with first episodes of PSP, manual aspiration seems similarly effective as tube thoracostomy and it might decrease duration of hospital stay. Therefore, manual aspiration would be considered as an initial treatment for first episodes of PSP.
책임저자: Do Kyun Kang
Department of Thoracic and Cardiovascular Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan Korea
발표자: Do Kyun Kang, E-mail : med7695@naver.com