PubMed · 12518751
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2002. Understanding pneumothorax.. https://pubmed.ncbi.nlm.nih.gov/12518751/
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The National Swedish Board of Health and Welfare has concluded that a minithoracotomy should be used for the insertion of a chest tube. Our opinion is that a less than 2 cm skin incision followed by blunt dissection through the chest wall is equally safe provided that the anatomical landmarks of the safe triangle are identified and the lung is not adherent to the chest wall. A prerequisite for safe treatment is an examination of the chest x-ray, supervision of chest tube function and the patient. Chest tube malfunction or complications should be managed urgently.
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Spontaneous idiopathic pneumothorax occurs frequently in young tall subjects with smoking habits, and is usually of good prognosis. Secondary pneumothorax is a life-threatening complication of an underlying lung disease, such as acute pneumonia. Pneumocystis carinii pneumonitis or chronic obstructive pulmonary disease. Short-term therapeutic options oppose non-traumatic needle aspiration, with a success rate of more than 50%, versus thoracic drainage, with a recurrence rate exceeding 35%. The existing literature also indicates that video-assisted surgery leads to a much better long-term prognosis than the standard drainage procedure, with a long-term recurrence rate of less than 2%, for equivalent hospital stays and complication rates. The widely accepted recommendation that surgery should be proposed only at the first or second pneumothorax recurrence may be challenged in the next decade.