WOFAPS 2025 8th World Congress of Pediatric Surgery

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Poster - 159

What means successful treatment of primary spontaneous pneumothorax in children: contrast of ER medicine and surgical point of view.

Ede Biro 1, Csaba Peterfia 2, Barnabas Rozsai 3
1 Department of Paediatrics, Division of Paediatric Surgery, University of Pécs Medical School, Pécs, Hungary
2 Department of Paediatrics, Pulmonology Unit, University of Pécs Medical School, Pécs, Hungary
3 Department of Paediatrics, Intensive Care Unit, University of Pécs Medical School, Pécs, Hungary

Purpose

Optimal management strategy of primary spontaneous pneumothorax (PSP) in children is still debated. Aim of the study was to evaluate the long-term outcome of our patients treated with PSP, focusing on recurrence, also to establish a PSP treatment protocol in our center.

Method

Retrospective study of PSP patient was done by reviewing medical database between 2010 and 2024. Demographic data, primary treatment method, radiology examinations, length of hospital stay, recurrence rate where observed.

Results

In 15 years, 66 patient (59 male, 7 female) where observed and treated with 74 episode of PSP. Mean age was 16.4 years (range 14.1-17.9). Presenting symptom was chest pain in 98% occurring at rest in 65%. Plain chest X-ray was used in all of them as primary diagnostic tool. There was no tension pneumothorax in any of them. PSP was right sided in 46%, left sided in 51%, bilateral in 3%. Chest CT performed in 57% (42 patients), showing no bullae in 31% (13 patients) of them. Initial treatment was observation& nasal +O2 in 31%, aspiration in 49%, drainage in 20% with a success rate of 65%, 44%, 53% respectively. Recurrent pneumothorax occurred in 50% in average 6 month (range 1-63 month) treated surgically in 78%. The mean hospital stay was 5 days (range 1-14 days). The mean followup time of the cohort was 3.8 years.

Conclusion

Our PSP cohort data’s matches scientific literature’s. Curative primary treatment choice however remains challenging. Surgical treatment is not CT result guided. Apical wedge resection with pleurectomy offers a quick and permanent solution. New PSP treatment algorithm was introduced in our center based on results above and recent publications.

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