Clinical Study of Primary Spontaneous Pneumothorax in Children

Background and purpose: Until now there is no clinical study of pediatric primary spontaneous pneumothorax (sPTX) in Taiwan. We therefore retrospectively studied patients of primary sPTX diagnosed at the Changhua Christian hospital in the past 10 years. Methods: We totally studied eighty-four patients of primary sPTX to delineate its clinical aspects. Patients with sPTX following trauma, iatrogenic injury, other predisposing lung disease and spontaneous tension pneumothorax in the neonatal period were excluded from the study. The diagnosis of pneumothorax was based on plain chest radiographs in all patients. Descriptive statistics was used in this study. Result: The mean age of patients was 17.1±0.6 years. Among 84 patients, 81(96.4%) had chest pain; 56 (66.7%) had dyspnea. Eighty-one (96.4%) had decreased breathing sound while three (3.6%) had absent breathing sound. Sixty-three patients underwent surgical procedures (62 video-assisted thoracoscopic surgery, VATS, and one limited thoracotomy). Bullae or blebs which almost occurred on the apex and the upper lobe of the lungs, were found in 61 patients. Twenty-one patients suffered from recurrent pneumothorax. The first recurred primary sPTX occurred in 21 patients (25%) and the second recurrence occurred in 9 of them (42%, 9/21). Smokers (44%, 4/9) had a higher recurrent rate than non-smokers (23%, 17/75). Conclusion: Early VATS approach should be considered, if primary sPTX occurs with severe symptoms and signs. Patient with a history of cigarette smoking has a higher recurrent rate of primary sPTX.

並列關鍵字

primary spontaneous pneumothorax ； video-assisted thoracoscopic surgery ； bullae ； children

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