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Surgery on Children

Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Management of spontaneous pneumothorax in children
Abstract
Pneumothorax is defined as air or gas accumulation in the pleural cavity. It can occur spontaneously or secondary to an underlying pulmonary disease or after a trauma. Spontaneous pneumothorax has been traditionally categorized as primary or secondary. Primary spontaneous pneumothorax(PSP) affects commonly young healthy people especially tall and thin adolescent males. Secondary cases may occur in patients with underlying pulmonary disease. The main aim in the treatment of pneumothorax is to empty the air in the pleural cavity and allow the lung to re-expand. There are two main approaches for the treatment of spontaneous pneumothorax; non-operative management options include bed rest, oxygen supplementation with watch-and-wait option, needle aspiration and surgical management options ranges from chest tube insertion to more invasive intervention such as lung resection, pleurodesis or bullae excision via thoracoscopy or thoracotomy. There is still a lack of consensus in the diagnostic approach and treatment strategies in PSP in children. Therefore, we aimed to review the clinical findings, radiological imagining, treatment options and surgical strategies in children with PSP.

Keywords : Spontaneous pneumothorax, diagnose, surgery, children

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1. RTH L. De I’auscultation mediate, ou traite du diagnostic des maladies des poumons et du Coeur, fonde principalement sur ce nouveau moyen d’exploration [On mediate ausculatation, or treatise on the dieseases of the lungs and heart, based principaaly on this new method of investigation]. Paris, Brosson and Chaude. 1819.
2. Kjaergaad H. Spontaneous pneumothorax in the apparently healthy. Acta Med Scand.1932;43:1e159.
3. Noppen M. Spontaneous pneumothorax: epidemiology, pathophysiology and cause. Eur Respir Rev. 2010;19(117):217-219.
4. Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med. 2000; 342(12):868-874.
5. O’Lone E, Elphick HE, Robinson PJ. Spontaneous pneumothorax in children: when is invasive treatment indicated? Pediatr Pulmonol. 2008; 43(1):41-46.
6. Akıncı SM, Soyer T, Yalçın Ş, et al. The results and outcome of primary spontaneous pneumothorax in adolescents. Int J Adolesc Med Health. 2020; 33(3):127-131.
7. Tschopp JM, Bintcliffe O, Astoul P, et al. ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax. Eur Respir J. 2015; 46(2):321-335.
8. Alifano M, Forti Parri SN, Bonfanti B, et al. Atmospheric pressure influences the risk of pneumothorax: beware of the storm! Chest. 2007;131(6):1877-1882.
9. Noppen M, Verbanck S, Harvey J, et al. Music: a new cause of primary spontaneous pneumothorax. Thorax. 2004;59(8):722-724.
10. Furia S, Breda C. Primary spontaneous pneumothorax in children and adolescents: a systematic review. Pediatric Medicine. 2019.
11. Bradnock TJ, Crabbe DCG. Pneumothorax. In: Parikh DH, Crabbe DCG et ak, editors. Pediatric thoracic surgery. London: Springer London; 2009. p.465-80.
12. Janssen JP, Schramel FM, Sutedja TGet al. Videothoracoscopic appearance of first and recurrent pneumothorax. Chest. 1995;108(2):330-334.
13. Lichter I, Gwynne JF. Spontaneous pneumothorax in young subjects. A clinical and pathological study. Thorax. 1971;26(4):409-417.
14. West JB. Distribution of mechanical stress in the lung, a possible factor in localisation of pulmonary disease. Lancet. 1971;1(7704):839-841.
15. Graham RB, Nolasco M, Peterlin B, et al. Nonsense mutations in folliculin presenting as isolated familial spontaneous pneumothorax in adults. Am J Respir Crit Care Med. 2005;172(1):39-44.
16. Barton EC, Maskell NA, Walker SP. Expert review on spontaneous pneumothorax: advances, controversies, and new directions. Semin Respir Crit Care Med. 2023;44(4):426-436.
17. Soyer T, Birben E, Türer ÖB, et al. MicroRNA levels in exhaled breath condensate of patients with esophageal atresia. Dis Esophagus. 2021;34(3): doaa082.
18. Soyer T, Birben E, Akıncı SM, et al. The miRNA-24, miRNA-21 expressions and matrix metalloproteinase-7 level in exhaled breath condensate of children with primary spontaneous pneumothorax. J Breath Res. 2022; 17(1):10.1088/1752-7163/aca928.
19. Grundy S, Bentley A, Tschopp JM. Primary spontaneous pneumothorax: a diffuse disease of the pleura. Respiration. 2012;83(3):185-189.
20. Seow A, Kazerooni EA, Pernicano PG, et al. Comparison of upright inspiratory and expiratory chest radiographs for detecting pneumothoraces. AJR Am J Roentgenol. 1996;166(2):313-316.
21. Kelly AM, Weldon D, Tsang AY, et al. Comparison between two methods for estimating pneumothorax size from chest X-rays. Respir Med. 2006;100(8): 1356-1359.
22. Phillips GD, Trotman-Dickenson B, Hodson ME, et al. Role of CT in the management of pneumothorax in patients with complex cystic lung disease. Chest. 1997;112(1):275-278.
23. Chan KK, Joo DA, McRae AD, et al. Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax in trauma patients in the emergency department. Cochrane Database Syst Rev. 2020;7(7):Cd013031.
24. Sugibayashi T, Walston SL, Matsumoto T, et al. Deep learning for pneumothorax diagnosis: a systematic review and meta-analysis. Eur Respir Rev. 2023;32(168):220259.
25. Light RW. Pleural diseases. Evidence-based Respiratory Med. 1995:521-536.
26. Collins CD, Lopez A, Mathie A, et al. Quantification of pneumothorax size on chest radiographs using interpleural distances: regression analysis based on volume measurements from helical CT. AJR Am J Roentgenol. 1995; 165(5):1127-1130.
27. Rhea JT, DeLuca SA, Greene RE. Determining the size of pneumothorax in the upright patient. Radiology. 1982;144(4):733-736.
28. MacDuff A, Arnold A, Harvey J. Management of spontaneous pneumothorax: British thoracic society pleural disease guideline 2010. Thorax. 2010;65(Suppl 2):ii18-31.
29. Baumann MH, Strange C, Heffner JE, et al. Management of spontaneous pneumothorax: an American College of chest physicians delphi consensus statement. Chest. 2001;119(2):590-602.
30. De Leyn P, Lismonde M, Ninane V, et al. Guidelines Belgian society of pneumology. Guidelines on the management of spontaneous pneumothorax. Acta Chir Belg. 2005;105(3):265-267.
31. Kelly AM, Druda D. Comparison of size classification of primary spontaneous pneumothorax by three international guidelines: a case for international consensus? Respir Med. 2008;102(12):1830-1832.
32. Choi SY, Kim YH, Jo KH, et al. Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax in children. Pediatr Surg Int. 2013; 29(5):505-509.
33. Soyer T, Dariel A, Dingemann J, et al. European pediatric surgeons’ association survey on the management of primary spontaneous pneumothorax in children. Eur J Pediatr Surg. 2022;32(5):415-421.
34. Karagöz A, Ünlüer EE, Akçay O, et al. Effectiveness of bedside lung ultrasound for clinical follow-up of primary spontaneous pneumothorax patients treated with tube thoracostomy. Ultrasound Q. 2018;34(4):226-232.
35. Shorthose M, Barton E, Walker S. The contemporary management of spontaneous pneumothorax in adults. Breathe (Sheff). 2023;19(4):230135.
36. Soccorso G, Anbarasan R, Singh M, et al. Management of large primary spontaneous pneumothorax in children: radiological guidance, surgical intervention and proposed guideline. Pediatr Surg Int. 2015;31(12):1139-1144.
37. Jouneau S, Ricard JD, Seguin-Givelet A, et al. SPLF/SMFU/SRLF/SFAR/SFCTCV Guidelinesfor the management of patients with primary spontaneous pneumothorax. Ann Intensive Care. 2023;13(1):88.
38. Gariépy M, Beaunoyer M, Miron MC, et al. Management and recurrence of spontaneous pneumothorax in children. Paediatr Child Health. 2020;25(2): 86-92.
39. Thelle A, Gjerdevik M, SueChu M, et al. Randomised comparison of needle aspiration and chest tube drainage in spontaneous pneumothorax. Eur Respir J. 2017;49(4):1601296.
40. Becker JC, Zakaluzny SA, Keller BA, et al. Clamping trials prior to thoracostomy tube removal and the need for subsequent invasive pleural drainage. Am J Surg. 2020;220(2):476-481.
41. Sag S, Elemen L. Management of primary spontaneous pneumothorax in children: current practices among Turkish pediatric surgeons. Turk Gogus Kalp Damar Cerrahisi Derg. 2023;31(2):222-228.
42. Bridevaux PO, Tschopp JM, Cardillo G, et al. Short-term safety of thoracoscopic talc pleurodesis for recurrent primary spontaneous pneumothorax: a prospective European multicentre study. Eur Respir J. 2011;38(4):770-773.
43. Brown SGA, Ball EL, Perrin K, et al. Conservative versus interventional treatment for spontaneous pneumothorax. N Engl J Med. 2020;382(5):405-415.
44. Walker SP, Bibby AC, Halford P, et al. Recurrence rates in primary spontaneous pneumothorax: a systematic review and meta-analysis. Eur Respir J. 2018;52(3):1800864.
45. Chee CB, Abisheganaden J, Yeo JK, et al. Persistent air-leak in spontaneous pneumothorax-clinical course and outcome. Respir Med. 1998;92(5):757-761.
46. Waller DA, Rengarajan A, Nicholson FH, et al. Delayed referral reduces the success of video-assisted thoracoscopic debridement for post-pneumonic empyema. Respir Med. 2001;95(10):836-840.
47. Tyson MD, Crandall WB. The surgical treatment of recurrent idiopathic spontaneous pneumothorax. J Thorac Surg. 1941;10(5):566-571.
48. Dzeljilji A, Rokicki W, Rokicki M, et al. New aspects in the diagnosis and treatment of primary spontaneous pneumothorax. Kardiochir Torakochirurgia Pol. 2017;14(1):27-31.
49. Vohra HA, Adamson L, Weeden DF. Does video-assisted thoracoscopic pleurectomy result in better outcomes than open pleurectomy for primary spontaneous pneumothorax? Interact Cardiovasc Thorac Surg. 2008;7(4): 673-677.
50. Tomasdottir GF, Torfason B, Isaksson HJ, et al. Comparison of video-assisted thoracoscopic surgery and limited axillary thoracotomy for spontaneous pneumothorax. Laeknabladid. 2007;93(5):405-412.
51. Kim KH, Kim HK, Han JY, et al. Transaxillary minithoracotomy versus video-assisted thoracic surgery for spontaneous pneumothorax. Ann Thorac Surg. 1996;61(5):1510-1512.
52. Elfeldt RJ, Schröder DW, Thies J. Long-term follow-up of different therapy procedures in spontaneous pneumothorax. J Cardiovasc Surg (Torino). 1994;35(3):229-233.
53. Yeo S, Chen J, Leow L, et al. Efficacy of mesh coverage in surgical bullectomy for primary spontaneous pneumothorax: a systematic review and meta-analysis. Surgeon. 2023;21(6):e378-e406.
54. Coker RK, Armstrong A, Church AC, et al. BTS clinical statement on air travel for passengers with respiratory disease. Thorax. 2022;77(4):329-350.
Article available in :
Volume 1, Issue 4, 2024
Page : 98-104
https://doi.org/10.51271/SOC-0023
Article Information
Received : 31 Tem 2024
Accepted : 05 Eyl 2024
Published : 05 Ara 2024
Corresponding Author :

Tutku Soyer: Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkiye

[email protected]
Citation : Gördü B, Soyer T. Management of spontaneous pneumothorax in children. Surg Child. 2024;1(4):98-104.

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