EN
TÜRKÇE
Poster - 52
Management of pediatric primary spontaneous pneumothorax: when should surgery be considered?
Ana Isabel Barros, Mário Rui Correia, Jorge Cagigal, Joana Sinde, Catarina Sousa-Lopes, José Banquart-Leitão, Ana Sofia Marinho, Catarina Carvalho
Department of Pediatric Surgery of Unidade Local de Saúde de Santo António
Purpose: Management of pediatric primary spontaneous pneumothorax (PSP) lacks standardized protocols, particularly recommended timing for surgical intervention. Current evidence suggests potential benefits of early surgery after 48 hours of drainage without resolution. We aimed to determine if persistent pneumothorax over a timeframe of drainage is associated with increased need for surgical intervention or ipsilateral recurrence.
Method: A retrospective analysis was conducted on all first episodes of PSP treated with chest tube drainage, in our department, between January 2018 and August 2024. Data collection included demographics, duration of thoracic drainage, need for surgical intervention, and recurrence. Fisher’s Exact Test and Phi Coefficient were used for statistical analysis. These were performed using SPSS Version 22.
Results: 29 patients were included, 89.7% were males. Mean body mass index of 18.6 kg/m². Median age at the first PSP was 16 years and 52.7% involved the left lung. Median chest drainage time was 71 hours. Apicectomy with mechanical pleurodesis was performed in 24% of patients. Ipsilateral recurrence occurred in 34% cases, most (80%) in patients without initial surgery. No statistically significant differences were found between need for surgery or recurrence after 48-hours (p=0.14 and p=0.43) or for recurrence after 72-hours (p=0,71). However, persistence of pneumothorax beyond 72 hours was significantly associated with the need for surgical intervention (p=0.02; phi coefficient of 0.58).
Conclusion: Our results suggest that a 72-hour drainage period may be a useful clinical threshold for determining the need for surgical intervention in PSP. Further research is warranted to validate these findings and refine management guidelines.