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Ambulatory Management of Large Spontaneous Pneumothorax with Small Bore Catheters: A Prospective Multicentre Cohort Study
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A5026 - Ambulatory Management of Large Spontaneous Pneumothorax with Small Bore Catheters: A Prospective Multicentre Cohort Study
Author Block: A. Salé1, M. Le Garrec2, M. Campion2, L. Sohier3, S. Jouneau2; 1CHU RENNES, Rennes, France, 2CHU RENNES, RENNES, France, 3CHBS, Lorient, France.
Introduction Spontaneous pneumothorax is a frequent condition that occurs mostly in young active patients. In the current recommendations, there is no consensus on the initial management and most of the patients are hospitalised and treated with chest tube. We confirm in this prospective multicentre study, the possibility of a near exclusive ambulatory management.Methods Between December 2013 and July 2017, we included patients with large spontaneous primary and secondary pneumothoraces in centre hospitalier of Lorient, Vitré and Rennes. Patients were treated with small bore pigtail catheter and one way valve and managed as outpatients following a specific algorithm. Patients were hospitalised at day 4 for suction and surgical pleurodesis was performed at day 6 in case of treatment failure. Patients were followed up for 1 year. Results On 148 patients (129 PSP, 19 SSP) 122 were exclusively managed as outpatient with an ambulatory success rate at day 4 of 82.5% and of 94 at day 6. Recurrence rate at 1 year was 28.3% for PSP versus 52.9% for SSP (p= 0.044 Hazard Ratio = 0.173; IC95% [0.031-0.954]). Number of complications was small with only 13 vaso-vagal episodes and 3 minor bleedings. Conclusion Our results are consistent with previous studies and confirm that the implementation of this management in new centres is possible with high success rate and few complications.
Author Block: A. Salé1, M. Le Garrec2, M. Campion2, L. Sohier3, S. Jouneau2; 1CHU RENNES, Rennes, France, 2CHU RENNES, RENNES, France, 3CHBS, Lorient, France.
Introduction Spontaneous pneumothorax is a frequent condition that occurs mostly in young active patients. In the current recommendations, there is no consensus on the initial management and most of the patients are hospitalised and treated with chest tube. We confirm in this prospective multicentre study, the possibility of a near exclusive ambulatory management.Methods Between December 2013 and July 2017, we included patients with large spontaneous primary and secondary pneumothoraces in centre hospitalier of Lorient, Vitré and Rennes. Patients were treated with small bore pigtail catheter and one way valve and managed as outpatients following a specific algorithm. Patients were hospitalised at day 4 for suction and surgical pleurodesis was performed at day 6 in case of treatment failure. Patients were followed up for 1 year. Results On 148 patients (129 PSP, 19 SSP) 122 were exclusively managed as outpatient with an ambulatory success rate at day 4 of 82.5% and of 94 at day 6. Recurrence rate at 1 year was 28.3% for PSP versus 52.9% for SSP (p= 0.044 Hazard Ratio = 0.173; IC95% [0.031-0.954]). Number of complications was small with only 13 vaso-vagal episodes and 3 minor bleedings. Conclusion Our results are consistent with previous studies and confirm that the implementation of this management in new centres is possible with high success rate and few complications.
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